| NPI | 1801818851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L SPENCE NELSON Orthodontist 719-278-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 104648) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |