| NPI | 1982433793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN SNIDER Owner 719-244-1548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-07-30 |