| NPI | 1578766010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE D NAZAROV Owner 720-842-4544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 8530) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |