| NPI | 1790153500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE C EDWARDS Office Manager 970-249-1898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7238) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |