# ADVANCED PLASTIC SURGERY CENTER, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447458591
- **Authorized official:** DR. MARK D FETTER M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (928) 777-0200

## Contact information

- **Practice address:** 1615 PETROGLYPH POINT DR, PRESCOTT, AZ 86301-6539
- **Practice address phone:** (928) 777-0200
- **Practice address fax:** (928) 443-1117
- **Mailing address:** 1615 PETROGLYPH POINT DR, PRESCOTT, AZ 86301-6539
- **Mailing address phone:** (928) 777-0200
- **Mailing address fax:** (928) 443-1117

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2007
- **Last updated:** 08/16/2007