| NPI | 1902432479 |
|---|---|
| Doing Business As | YOUNG AT HEART DENTISTRY LA JUNTA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL R HERRERA Business Manager 719-696-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-05-05 |