| NPI | 1619405396 |
|---|---|
| Doing Business As | ORAL SURGERY SPECIALISTS OF PUEBLO |
| Entity Type | Organization |
| Authorized Contact | TYLER E NELSON Owner 719-597-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2017-05-25 |