| NPI | 1972827723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE HOUSEWRIGHT Owner/Operator 719-495-1230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 8767) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |