| NPI | 1972625812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE SUMMERS Credentialing 303-285-6098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 6097) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |