| NPI | 1629567607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT V LAW Owner 970-226-5505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2017035887) |
| Enumeration Date | 2018-05-06 |
| Last Update Date | 2018-05-06 |