NPI | 1609904101 |
---|---|
Doing Business As | AWESOME PEDODONTICS |
Entity Type | Organization |
Authorized Contact | TOBIAS M. DERLOSHON President 970-669-1122 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2007-02-28 |
Last Update Date | 2014-05-13 |