| NPI | 1689036220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN WALTER ANDREWS Owner 719-596-3138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 7466) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |