| NPI | 1669618740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE LEA SMITH Regional Director 720-371-2309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9694) |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2009-03-10 |