| NPI | 1780134999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUCK SKINNER Owner/President 303-774-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00201981) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 10514) |
| 122300000X Dentist (Licence: CO 201865) | |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |