| NPI | 1932943701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN B SIKES Doctor/Owner 970-516-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-09-17 |