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 |