Individual
EDGAR PAUL POREMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
2997 BROADMOOR VALLEY RD, COLORADO SPGS, CO 80906-4405
(719) 576-0149
(719) 579-5373
Mailing address
2997 BROADMOOR VALLEY RD, COLORADO SPGS, CO 80906-4405
(719) 576-0149
(719) 579-5373
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
105719
CO
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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