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
BRIAN FANGMAN DDS (OWNER/ORAL SURGERON)
(720) 328-4990
Entity
Organization
Contact information
Practice address
18335 E 103RD AVE UNIT 102, COMMERCE CITY, CO 80022-3103
(720) 328-4990
(720) 328-4994
Mailing address
5600 W 44TH AVE # 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
NPI
NY
05
—
1952791964
—
CO
Enumeration date
02/07/2022
Last updated
02/08/2022
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