| NPI | 1790900272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE DELANEY Insurance Coordinator 970-669-1236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8096) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |