| NPI | 1770833113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN ROGER ROCKNAK Owner 970-685-1371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1302) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |