| NPI | 1932358496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN RUSH Business Manager 719-282-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN 9665) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO DEN 9665) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2022-06-10 |