| NPI | 1528553070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR JOHNSON Managing Partner 720-432-8738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO DEN.00203418) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO DEN.00203577) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2018-06-27 |