| NPI | 1750937124 |
|---|---|
| Doing Business As | GRACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | COLLEEN JENSON Owner 719-532-1007 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |