| NPI | 1982800264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CHRISTIANSEN Owner 719-597-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 8422) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2009-01-07 |