| NPI | 1558515791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ERIN MORRIS Head Of Payor Strategy 719-464-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027369) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2025-03-12 |