| NPI | 1629421474 |
|---|---|
| Doing Business As | ASPEN DENTAL |
| Entity Type | Organization |
| Authorized Contact | CATHY CLUETT Provider Enrollment Specialist 3154-546-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |