| NPI | 1649390220 |
|---|---|
| Doing Business As | ACADEMY BLVD ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | LEOPOLDO RODRIGUEZ Owner 719-596-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CO 7181) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |