| NPI | 1730545393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA FOWLER President/Dentist 970-352-5448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 10414) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |