Glenwood Oral Surgery, P.C.
Clinic/Center, Oral and Maxillofacial Surgery in Glenwood Springs, CO. Organization (NPI-2).
NPI number1043480452
StatusActive
Last updated in NPPESMar 3, 2008
Details
- NPI
- 1043480452
- Entity type
- Organization (NPI-2)
- Legal business name
- Glenwood Oral Surgery, P.C.
- Organization subpart
- No
- Enumeration date
- Mar 3, 2008
- Last updated
- Mar 3, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QS0112X | Clinic/Center, Oral and Maxillofacial Surgery | Hd104468 | CO | Yes |
Practice location
406 South Hyland Park DrSuite B
Glenwood Springs, CO 81601
Phone 970-945-9644 · Fax 970-945-0760
Mailing address
406 South Hyland Park DrSuite B
Glenwood Springs, CO 81601
Phone 970-945-9644 · Fax 970-945-0760
Authorized official
George Wayne Haltom
Owner
9709459644
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