| NPI | 1639427586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA SANDOVAL Office Manager 719-633-0049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7185) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2012-08-27 |