Organization
EDGAR P POREMBA DDS MSD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR P POREMBA DDS MSD (ORTHODONTIST)
(719) 576-0149
Entity
Organization
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
01/23/2007
Last updated
08/22/2020
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