| NPI | 1982149514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD PACHELLO Chief Revenue Officer 720-475-6482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA DN1857191) |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2026-03-11 |