| NPI | 1609875830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOEL HAYUTIN Manager 720-886-0808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 6181) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WY 915) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-08-22 |