| NPI | 1861893067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAUL JACKSON Owner/Dentist 303-447-2872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6979) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |