| NPI | 1992114763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HARVEY Owner 303-989-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00009510) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00201853) |
| 122300000X Dentist (Licence: CO 10062) | |
| 122300000X Dentist (Licence: CO 9645) | |
| 122300000X Dentist (Licence: CO 9389) | |
| 1223P0300X Dentist Periodontics (Licence: CO 9692) | |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2015-03-31 |