| NPI | 1871860296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L HAMAN Owner 719-596-6920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 7156) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |