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Organization

BOULDER ORAL SURGERY

Active
Parent organization
TERRENCE NEDBALSKI DDS PLLC
Other names
Boulder Oral Surgery
Organization subpart
Yes

Provider details

NPI number
Legal business name
TERRENCE NEDBALSKI DDS PLLC
Authorized official
DR. TERRENCE ROBERT NEDBALSKI DDS (OWNER)
(303) 447-9735
Entity
Organization

Contact information

Practice address
3450 PENROSE PL STE 120, BOULDER, CO 80301-1800
(303) 447-9735
(303) 447-9735
Mailing address
3450 PENROSE PL, SUITE 120, BOULDER, CO 80301-1800
(303) 447-9735
(303) 447-1025

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9410
CO

Other

Enumeration date
12/13/2017
Last updated
03/17/2018
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