Organization
DESERT SOUTHWEST ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN BIDWELL SIKES DMD (OWNER)
(970) 516-4100
Entity
Organization
Contact information
Practice address
33 N ELM ST STE B, CORTEZ, CO 81321-3105
(970) 516-4100
(970) 632-6178
Mailing address
33 N ELM ST STE B, CORTEZ, CO 81321-3105
(205) 572-1035
(970) 632-6178
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01385828
—
CO
05
—
22603085
—
NM
05
—
251853
—
AZ
Enumeration date
03/01/2022
Last updated
10/06/2022
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