| NPI | 1609899038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARLIE JOACHIM BURNHAM Owner/Dentist 970-229-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8146) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 8353) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |