| NPI | 1649677378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE WOLBAUM Owner 303-766-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 10189) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2014-11-24 |