| NPI | 1619353430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ALAN GOULD Owner 719-367-7418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO DEN00009256) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |