| NPI | 1962401216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JOSEPH KLOBERDANZ President 970-330-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 594) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-08-22 |