| NPI | 1760708176 |
|---|---|
| Doing Business As | PEREGRINE FAMILY DENTISTRY, P.C. |
| Entity Type | Organization |
| Authorized Contact | CLARISA KIM MANTANONA D.D.S./President 719-314-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 9025) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2010-04-09 |