| NPI | 1710360144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD HASSEL PACK Dentist 970-565-9569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CO 10266) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |