Organization
AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES EDWARD BERWICK DDS (PRESIDENT)
(719) 597-4060
Entity
Organization
Contact information
Practice address
3100 N ACADEMY BLVD, SUITE 213, COLORADO SPRINGS, CO 80917-5321
(719) 597-4060
(719) 574-2140
Mailing address
3100 N ACADEMY BLVD, SUITE 213, COLORADO SPRINGS, CO 80917-5321
(719) 597-4060
(719) 574-2140
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7202
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76159361
—
CO
Enumeration date
03/14/2007
Last updated
08/22/2020
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