| NPI | 1942429147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ERIC OUELLETTE Dentist 303-296-1402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 006952) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-03-10 |