| NPI | 1851609655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL ADAM AVANT President 719-596-1363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 6191) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |