| NPI | 1629455084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUCK SKINNER Owner/President 303-665-7505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 10514) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 201865) |
| 122300000X Dentist (Licence: CO 63) | |
| 122300000X Dentist (Licence: CO 104857) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2016-01-05 |