| NPI | 1881717007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA N MOYER Secretary Treasurer 303-973-4424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 104977) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 104977) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 104978) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2025-09-11 |