| NPI | 1922175793 |
|---|---|
| Former Legal Business Name | PEAK VISTA FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JEROME TAFOLLA Dentist/Owner 719-598-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2018-11-07 |