| NPI | 1659654564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO JUAN LUCERO Owner 719-599-5980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 80) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |