| Desert Southwest Oral And Facial Surgery | |
|
33 N Elm St Ste B Cortez CO 81321-3105 | |
| (970) 516-4100 | |
| (970) 632-6178 |
| Full Name | Desert Southwest Oral And Facial Surgery |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 33 N Elm St Ste B, Cortez, Colorado |
| Authorized Official Name and Position | Justin Bidwell Sikes (OWNER) |
| Authorized Official Contact | 9705164100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Southwest Oral And Facial Surgery 33 N Elm St Ste B Cortez CO 81321-3105 Ph: (205) 572-1035 | Desert Southwest Oral And Facial Surgery 33 N Elm St Ste B Cortez CO 81321-3105 Ph: (970) 516-4100 |
| NPI Number | 1376299131 |
|---|---|
| Provider Enumeration Date | 03/01/2022 |
| Last Update Date | 10/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376299131 | NPI | - | NPPES |
| 01385828 | Medicaid | CO | |
| 251853 | Medicaid | AZ | |
| 22603085 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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