| NPI | 1649715897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JAMES DIEMER Owner 303-202-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO D10220) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2016-12-27 |