Organization
AESTHETIC & MAXILLOFACIAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL CHARLES MADLOCK MD, DMD (DOCTOR)
(720) 878-8999
Entity
Organization
Contact information
Practice address
1610 CANYON BLVD, BOULDER, CO 80302-5407
(303) 938-0130
(303) 245-0405
Mailing address
1610 CANYON BLVD, BOULDER, CO 80302-5407
(303) 938-0130
(303) 245-0405
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/05/2008
Last updated
11/18/2008
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