BLUE RIVER ORAL SURGERY; NPI #1578706651

Contact Information

BLUE RIVER ORAL SURGERY

975 NORTH TEN MILE DRIVE
SUITE E 11
FRISCO, CO 80443-4998

Phone: 970-668-1314
Fax: 970-668-1057
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for BLUE RIVER ORAL SURGERY

NPI Number 1578706651

LBN Legal business name BLUE RIVER ORAL SURGERY

Authorized official KARL HEGGLAND - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/20/2009

Last updated 04/20/2009 - About 17 years ago

Identifiers

License #

8755

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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