| NPI | 1558610113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN SEAN BINGHAM Dentist Owner 970-353-2340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9702) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |