| NPI | 1952677973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS STONE Owner 303-806-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CO 10547) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CO 100972) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2012-03-23 |