| NPI | 1922128859 |
|---|---|
| Doing Business As | PERFECT TEETH - EAST 104TH AVENUE P.C. |
| Entity Type | Organization |
| Authorized Contact | LAURIE SUMMERS Credentialing 303-285-6098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6097) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |