| NPI | 1992261820 |
|---|---|
| Doing Business As | GREELEY KIDS DENTAL AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | KEITH VAN TASSELL Dentist 970-330-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |