# MOUNTAIN ORAL & MAXILLOFACIAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245676907
- **Authorized official:** DR. ROBERT CORY RYAN MD. DDS (PRESIDENT)
- **Authorized official phone:** (404) 694-2584

## Contact information

- **Practice address:** 7913 ALLISON WAY, SUITE 101, ARVADA, CO 80005-5032
- **Practice address phone:** (303) 422-2990
- **Practice address fax:** (303) 425-4386
- **Mailing address:** 7913 ALLISON WAY, SUITE 101, ARVADA, CO 80005-5032
- **Mailing address phone:** (303) 422-2990
- **Mailing address fax:** (303) 425-4386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 00201797 | CO | Yes |

## Other

- **Enumeration date:** 05/21/2013
- **Last updated:** 05/21/2013