| NPI | 1619108073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN VOSTATEK Managing Partner 719-598-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 9884) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |