Organization
DRY SURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBEN DATKHAEV (PRESIDENT)
(720) 540-7155
Entity
Organization
Contact information
Practice address
3715 W 95TH PL, WESTMINSTER, CO 80031-2603
(720) 540-7155
(720) 540-7155
Mailing address
3715 W 95TH PL, WESTMINSTER, CO 80031-2603
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
SA#1058
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA#1058 CO
SURG ASSIST
CO
Enumeration date
02/10/2015
Last updated
02/10/2015
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