| NPI | 1811159551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA VILLAGRANA Operations Manager 720-833-5068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 122300000X Dentist | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-11-01 |