| NPI | 1699048439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHON PETERSON Owner/Orthodontist 303-452-4656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 8741) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2014-04-15 |