| NPI | 1720214638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE E HARTSHORN Office Manager 720-338-9778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2020-06-22 |