| NPI | 1790010809 |
|---|---|
| Former Legal Business Name | PERFECT TEETH - NORTH WILMOT PC |
| Entity Type | Organization |
| Authorized Contact | LAURIE K ARBUCKLE Credentialing Specialist 303-285-6098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 4821) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 6097) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2011-09-09 |