Organization
ADVANCED IMPLANT AND ORAL SURGERY
Active
Other names
Sonoma Oral and Facial Surgery of Yuma
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER A SPANGANBERG DDS (OWNER)
(480) 279-3113
Entity
Organization
Contact information
Practice address
1325 W 16TH ST STE 3, YUMA, AZ 85364-4496
(928) 329-6447
(928) 782-8036
Mailing address
1325 W 16TH ST STE 3, YUMA, AZ 85364-4496
(928) 329-6447
(928) 782-8036
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
Other
Enumeration date
03/09/2018
Last updated
04/17/2018
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