| NPI | 1699100982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA COMER Office Manager 719-582-4222 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7989) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |