Organization
FRONT RANGE OTOLARYNGOLOGY & FACIAL PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN C CAVANAUGH MD (OWNER MD)
(720) 494-9111
Entity
Organization
Contact information
Practice address
1325 DRY CREEK DR, SUITE 103, LONGMONT, CO 80503-7731
(720) 494-9111
(720) 494-9555
Mailing address
1325 DRY CREEK DR, SUITE 103, LONGMONT, CO 80503-7731
(720) 494-9111
(720) 494-9555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207YS0123X
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91282888
—
CO
05
—
94320381
—
CO
Enumeration date
06/29/2007
Last updated
05/24/2016
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