| NPI | 1932520707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON LAWRENCE WHITELEY President 303-321-0828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 105400) |
| Enumeration Date | 2013-12-22 |
| Last Update Date | 2013-12-22 |