| NPI | 1982954855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CURTIS WOOLF Chief Administrative Officer 719-242-7210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2018-03-17 |