| NPI | 1699941716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA MONICA LONGO President 719-481-6788 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6519) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2008-05-08 |