| NPI | 1831424738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE M GEORGE Doctor 719-598-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 6134) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |