| NPI | 1871283572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNAFER MARY CORRELL Revenue Cycle Manager 303-931-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-06-27 |