| NPI | 1609309707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT FREDERICK Owner/Doctor 303-317-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 10115) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |