Organization
COMFORT DENTAL ORAL SURGERY COLORADO SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR JOHNSON DMD (MANAGING PARTNER)
(720) 432-8738
Entity
Organization
Contact information
Practice address
556 W. HWY 105, MONUMENT, CO 80132
(720) 432-8738
Mailing address
14095 W 62ND AVE, ARVADA, CO 80004-3613
(303) 919-1902
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN.00203418
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN.00203577
CO
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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