Organization
FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC
Active
Other names
Altitude Oral and Facial Surgery PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN FANGMAN DDS (OWNER/ORAL SURGEON)
(720) 328-4990
Entity
Organization
Contact information
Practice address
5600 W 44TH AVE UNIT 100, DENVER, CO 80212-7339
(720) 328-4990
(720) 328-4994
Mailing address
5600 W 44TH AVE UNIT 100, DENVER, CO 80212-7339
(720) 328-4990
(720) 328-4994
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609027556
INDIVIDUAL NPI
NY
05
—
1952791964
—
CO
Enumeration date
02/04/2022
Last updated
02/08/2022
Update your record
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