| NPI | 1568752426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KENT ROLLERT Owner 303-503-5039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 7699) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |