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 |