Organization
COLORADO REGIONAL ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE M CORONA LPN (OFFICE MANAGER)
(303) 431-0033
Entity
Organization
Contact information
Practice address
8025 CLUB CREST DRIVE, ARVADA, CO 80005
(303) 431-0033
(303) 431-0507
Mailing address
8025 CLUB CREST DRIVE, ARVADA, CO 80005
(303) 431-0033
(303) 431-0507
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0796
CO
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
0796
CO
Other
Enumeration date
04/23/2009
Last updated
04/23/2009
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