Organization
GLENWOOD ORAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE WAYNE HALTOM III D.D.S. (OWNER)
(970) 945-9644
Entity
Organization
Contact information
Practice address
406 SOUTH HYLAND PARK DR, SUITE B, GLENWOOD SPRINGS, CO 81601
(970) 945-9644
(970) 945-0760
Mailing address
406 SOUTH HYLAND PARK DR, SUITE B, GLENWOOD SPRINGS, CO 81601
(970) 945-9644
(970) 945-0760
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
HD104468
CO
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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