| NPI | 1962938167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYN M HYATT Office Manager 970-249-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 7485) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CO 6675) |
| 1223G0001X Dentist General Practice (Licence: CO 202414) | |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2017-05-08 |