| NPI | 1548954191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE GILLESPIE Owner 720-436-1303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |