Organization
CHEYENNE MOUNTAIN ORAL SURGERY PC
Active
Parent organization
CHEYENNE MOUNTAIN ORAL SURGERY PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHEYENNE MOUNTAIN ORAL SURGERY PC
Authorized official
SANDRA RENEHAN MD (ADMINISTRATOR)
(719) 540-6350
Entity
Organization
Contact information
Practice address
640 SOUTHPOINTE CT STE 150, COLORADO SPRINGS, CO 80906-3884
(719) 540-6350
(719) 527-9487
Mailing address
640 SOUTHPOINTE CT STE 150, COLORADO SPRINGS, CO 80906-3884
(719) 540-6350
(719) 527-9487
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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