| NPI | 1780412700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY G. GOGGANS President 719-569-5715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |