Organization
TRAUMA AND EMERGENCY SUBSPECIALTY SURGEONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN J WILLOUGHBY M.D. (SOLE OWNER)
(303) 320-5700
Entity
Organization
Contact information
Practice address
1745 SHEA CENTER DR, SUITE 400, HIGHLANDS RANCH, CO 80129-1537
(303) 774-1974
Mailing address
1745 SHEA CENTER DR, SUITE 400, HIGHLANDS RANCH, CO 80129-1537
(303) 774-1974
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
40115
CO
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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