| NPI | 1588771612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD PALMER President 719-593-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 3668) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |