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Organization
ADVANCED IMPLANT AND ORAL SURGERY
Active
Organization
ADVANCED IMPLANT AND ORAL SURGERY
Active
Other names
Sonoma Oral and Facial Surgery of Yuma
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER A SPANGANBERG DDS (OWNER)
(480) 279-3113
Entity
Organization
Contact information
Practice address
1325 W 16TH ST STE 3, YUMA, AZ 85364-4496
(928) 329-6447
(928) 782-8036
Mailing address
1325 W 16TH ST STE 3, YUMA, AZ 85364-4496
(928) 329-6447
(928) 782-8036
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
NULL
Other
Enumeration date
03/09/2018
Last updated
04/17/2018
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