| NPI | 1679046155 |
|---|---|
| Doing Business As | NORTHWEST PEDIATRIC DENTAL--RED OAK |
| Entity Type | Organization |
| Authorized Contact | GINA ABROTSKY Credentialing Specialist 720-603-4788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |