| NPI | 1790171429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT C. DAVIS Dentist 719-542-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 3556) |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-04-09 |