| NPI | 1639669583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOESEPH MATHEW POTTER Owner 720-724-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO DEN.00202685) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |