| NPI | 1730542150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOMI M LIM Owner/Dentist 719-418-2456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 201804) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2016-04-02 |