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 |