| NPI | 1750759528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LEYSTER President 360-701-9126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CO 00202648) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |