Organization · Type 2 NPI

Four Corners Oral and Maxilliofacial Surgery

Dental Clinic/Center · Durango, CO

NPI number 1104162452 Active

Practice location

72 Suttle St, S# E
Durango, CO 81303-6829

Fax (970) 385-5077

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XC36335 (CO)

Dental Clinic/Center: Definition to come...

6 other providers at this address

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About NPI 1104162452

Four Corners Oral and Maxilliofacial Surgery's National Provider Identifier is 1104162452, issued on Dec 13, 2012. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Durango, CO. The record was last updated on Dec 13, 2012.