| NPI | 1609570225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BLANCHARD Adiministration 970-759-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-03-30 |