| NPI | 1962615492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J PURCELL Owner 719-543-7123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 7055) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-01-18 |