| NPI | 1609390632 |
|---|---|
| Doing Business As | 38TH MODERN DENTAL |
| Entity Type | Organization |
| Authorized Contact | SCOTT FREDERICK Owner 303-515-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |