| NPI | 1861933632 |
|---|---|
| Doing Business As | GALLATIN VALLEY PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JUSTIN MATTHEW STEVENS President 303-885-6141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MT 13304) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |