Glenwood Oral Surgery, P.C.

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

HD104468 Issued in CO

Legal business name

GLENWOOD ORAL SURGERY, P.C.

Practice address

406 South Hyland Park Dr
Suite B
Glenwood Springs, CO 81601

Phone

(970) 945-9644

Fax

(970) 945-0760

NPI assigned

Mar 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. George Wayne Haltom III, D.D.S.NPI 1619051968

Title

Owner

Phone

(970) 945-9644

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George Wayne Haltom III, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Glenwood Springs, CO
  • NPI 1619051968
  NPD (past) Authorized official
• Colin Trevor Galbraith, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Glenwood Springs, CO
  • NPI 1104123629
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1043480452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SOUTH HYLAND PARK DR",
            "address_2": "SUITE B",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "81601",
            "telephone_number": "970-945-9644",
            "fax_number": "970-945-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SOUTH HYLAND PARK DR",
            "address_2": "SUITE B",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "81601",
            "telephone_number": "970-945-9644",
            "fax_number": "970-945-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD ORAL SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "HALTOM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-945-9644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "HD104468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenwood Anesthesia Professionals, PC
• Glenwood Investments & Associates, LLC
• Glenwood Investments & Associates, LLC
• Glenwood Medical Assoc
• Glenwood Medical Associates PC
• Glenwood Springs Harmony House Inc.
• GMJM, LLC
• Eric Matthew Gochanour, MD
• Elizabeth Naomi Godbey, M.A.
• Going Green Tours and Rentals

• All providers in Glenwood Springs, CO
• Oral and Maxillofacial Surgery Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.