| NPI | 1528644879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD PACHELLO Chief Revenue Officer 720-475-6482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2026-03-11 |