| NPI | 1720748999 |
|---|---|
| Doing Business As | PROMENADE DENTIST OFFICE AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | JASON D CONRAD Owner 720-805-2425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2021-12-29 |