| NPI | 1740382209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE R GILLESPIE Owner 303-296-4080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 104587) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2020-08-22 |