| NPI | 1871995506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA BOGDASAROVA Owner 720-404-8805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA dn014759) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |