NPI | 1972656403 |
---|---|
Entity Type | Organization |
Authorized Contact | MARISSA ANNE NICHOLSON Office Manager 720-489-9800 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO 9054) |
Additional Taxonomies | 122300000X Dentist (Licence: CO 6619) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2020-08-22 |