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Organization
FANGMAN & IVEY ORAL AND FACIAL SURGERY PLLC
Active
Organization
FANGMAN & IVEY ORAL AND FACIAL SURGERY PLLC
Active
Other names
Altitude Oral and Facial Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JOHN FANGMAN DDS (PRESIDENT/CEO)
(720) 328-4990
Entity
Organization
Contact information
Practice address
5600 W 44TH AVE STE 100, DENVER, CO 80212-7339
(720) 328-4990
(720) 328-4994
Mailing address
5600 W 44TH AVE STE 100, DENVER, CO 80212-7339
(720) 328-4990
(720) 328-4994
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
NULL
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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