| Academy Blvd Oral Surgery | |
|
1304 N Academy Blvd Suite 205 Colorado Springs CO 80909-3325 | |
| (719) 596-8440 | |
| (719) 572-8934 |
| Full Name | Academy Blvd Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 1304 N Academy Blvd, Colorado Springs, Colorado |
| Authorized Official Name and Position | Leopoldo Rodriguez (OWNER) |
| Authorized Official Contact | 7195963939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Academy Blvd Oral Surgery 1304 N Academy Blvd Suite 205 Colorado Springs CO 80909-3325 Ph: (719) 596-8440 | Academy Blvd Oral Surgery 1304 N Academy Blvd Suite 205 Colorado Springs CO 80909-3325 Ph: (719) 596-8440 |
| NPI Number | 1649390220 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649390220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 7181 (Colorado) | Primary |
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