Organization
ROCKY MOUNTAIN ORAL SURGERY
Active
Other names
R. P. Hanawalt, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD P. HANAWALT DDA (PRESIDENT)
(970) 493-4434
Entity
Organization
Contact information
Practice address
1029 ROBERTSON ST, FORT COLLINS, CO 80524-3926
(970) 493-4434
Mailing address
1029 ROBERTSON ST, FORT COLLINS, CO 80524-3926
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
203
CO
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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