# NESIBA SURGICAL ARTS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cherry Creek Oral Surgery and Dental Implants
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093311300
- **Authorized official:** JOHN R NESIBA MD, DDS (OWNER)
- **Authorized official phone:** (303) 777-1603

## Contact information

- **Practice address:** 3955 E EXPOSITION AVE STE 520, DENVER, CO 80209-5030
- **Practice address phone:** (303) 777-1603
- **Practice address fax:** (303) 777-1694
- **Mailing address:** PO BOX 1119, WICHITA, KS 67201-1119
- **Mailing address phone:** (303) 777-1603
- **Mailing address fax:** (303) 777-1694

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2020
- **Last updated:** 12/10/2020