| NPI | 1972169654 |
|---|---|
| Former Legal Business Name | FAMILY DENTAL CLINIC LLC |
| Entity Type | Organization |
| Authorized Contact | JINA RASOULI Dentist 720-232-3095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2020-03-09 |