| NPI | 1881999142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY DAVID WATERHOUSE Owner 303-927-6945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KS 60697) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2011-01-18 |