# FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Altitude Oral Maxillofacial Implant Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952791964
- **Authorized official:** DR. BRIAN FANGMAN DDS (ORAL MAXILLOFACIAL SURGEON/OWNER)
- **Authorized official phone:** (720) 328-4990

## Contact information

- **Practice address:** 1440 BLAKE ST STE 100, DENVER, CO 80202-1475
- **Practice address phone:** (720) 328-4990
- **Practice address fax:** (720) 328-4994
- **Mailing address:** 1440 BLAKE ST STE 100, DENVER, CO 80202-1475
- **Mailing address phone:** (720) 328-4990
- **Mailing address fax:** (720) 328-4994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 202239 | CO | Yes |

## Other

- **Enumeration date:** 01/28/2015
- **Last updated:** 02/08/2022