# DESERT SOUTHWEST ORAL AND FACIAL SURGERY

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

## Provider details

- **NPI number:** 1376299131
- **Authorized official:** DR. JUSTIN BIDWELL SIKES DMD (OWNER)
- **Authorized official phone:** (970) 516-4100

## Contact information

- **Practice address:** 33 N ELM ST STE B, CORTEZ, CO 81321-3105
- **Practice address phone:** (970) 516-4100
- **Practice address fax:** (970) 632-6178
- **Mailing address:** 33 N ELM ST STE B, CORTEZ, CO 81321-3105
- **Mailing address phone:** (205) 572-1035
- **Mailing address fax:** (970) 632-6178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/01/2022
- **Last updated:** 10/06/2022