| NPI | 1881099935 |
|---|---|
| Doing Business As | LONGMONT PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY NICHOLS Owner 303-994-0213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2014-10-31 |