Organization
EVERGREEN ORAL AND MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON JUNDT DDS, MD (OWNER / SURGEON)
(720) 990-5500
Entity
Organization
Contact information
Practice address
28000 MEADOW DR UNIT 110, EVERGREEN, CO 80439-8395
(720) 990-5500
(720) 990-5501
Mailing address
28000 MEADOW DR UNIT 110, EVERGREEN, CO 80439-8395
(720) 990-5500
(720) 990-5501
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN.00202720
CO
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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