| NPI | 1700502101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE SCOTT Fin Adm 719-545-2722 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-12-15 |