| NPI | 1740834381 |
|---|---|
| Doing Business As | COLORADO ORAL SURGERY GROUP |
| Entity Type | Organization |
| Authorized Contact | MICHELLE JOHNSON Credentialing Specialist 509-315-8338 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |