| 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 |