| NPI | 1700283488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE DUNN WILSON Owner 303-913-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: ME 3671) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |