| NPI | 1700099280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI MAE JIMISON President 970-663-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7479) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |