| NPI | 1871961193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID P. PHAM Dentist 303-768-8848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 7074) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2015-09-03 |