National Provider Identifier Database

BLUE RIVER ORAL SURGERY
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

BLUE RIVER ORAL SURGERY
975 NORTH TEN MILE DRIVE
SUITE E 11
FRISCO, CO80443-4998
Phone: 970-668-1314
Fax: 970-668-1057
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for BLUE RIVER ORAL SURGERY

NPI Number 1578706651
Legal business name
LBN
BLUE RIVER ORAL SURGERY
Authorized official KARL HEGGLAND - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 04/20/2009
Last updated 04/20/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • CO License #: 8755

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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