| NPI | 1902213135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG L RODRIGUEZ Adminstrator 719-633-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7157) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |