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Organization
ALTITUDE SURGERY CENTER LONE TREE PLLC
Active
Organization
ALTITUDE SURGERY CENTER LONE TREE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JOHN FANGMAN DDS (OWNER)
(720) 328-4990
Entity
Organization
Contact information
Practice address
10375 PARK MEADOWS DR STE 150B, LONE TREE, CO 80124-6735
(720) 328-4990
(720) 328-4994
Mailing address
10375 PARK MEADOWS DR STE 150B, LONE TREE, CO 80124-6735
(720) 328-4990
(720) 328-4994
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609027556
INDIVIDUAL NPI
NY
01
—
1770091720
GROUP NPI ROBINSON AND FANGMAN COSMETIC SURGERY LONE TREE, PLLC
CO
05
—
1952791964
—
CO
Enumeration date
07/10/2018
Last updated
07/10/2018
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