| NPI | 1770738726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTTY NEIL VANDUSEN Proprietor 970-255-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 100986) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2008-11-18 |