| NPI | 1821025768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BRENT GELLER President Owner 719-545-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 55) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-08-22 |