Organization
EXCELLENCE IN ORAL & MAXILLOFACIAL SURGERY
Active
Organization
EXCELLENCE IN ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKKI BIERNACKI (PRACTICE MANAGER)
(719) 592-9222
Entity
Organization
Contact information
Practice address
1755 TELSTAR DR, SUITE 210, COLORADO SPRINGS, CO 80920-1016
(719) 592-9222
(719) 592-9682
Mailing address
1755 TELSTAR DR, SUITE 210, COLORADO SPRINGS, CO 80920-1016
(719) 592-9222
(719) 592-9682
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6709
CO
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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