| NPI | 1902024425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALCOLM EDWARD BOONE President 303-799-1715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 104302) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2020-08-22 |