Organization
ADVANCED ORAL & MAXILLOFACIAL SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RHETT MARVIN QUIST DDS (OWNER)
(719) 359-8652
Entity
Organization
Contact information
Practice address
6160 TUTT BLVD, SUITE 250, COLORADO SPRINGS, CO 80923-3500
(719) 359-8652
(719) 623-5771
Mailing address
6160 TUTT BLVD, SUITE 250, COLORADO SPRINGS, CO 80923-3500
(719) 359-8652
(719) 623-5771
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8040
CO
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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