| NPI | 1912354812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ANDERSON Owner 303-400-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO 202145) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CO 10488) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-05-20 |