Organization
ORTHODONTICS OF SOUTHWEST COLORADO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA SALAZAR (BILLING)
(505) 592-0482
Entity
Organization
Contact information
Practice address
101 S MAPLE ST, CORTEZ, CO 81321-3562
(970) 565-3531
Mailing address
4760 N BUTLER AVE STE B, FARMINGTON, NM 87401-0816
(505) 592-0482
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/24/2019
Last updated
02/04/2019
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