| NPI | 1891200309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HAMBLETON Owner / Surgeon 720-996-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |