| NPI | 1811075740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J MUCCI Owner 970-223-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8120) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 3401) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |