NPI | 1770792939 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID LEROY BANKS President 970-879-5439 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 104122) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2020-08-22 |