Fangman & Ivey Oral And Facial Surgery Pllc | |
5600 W 44th Ave Ste 100 Denver CO 80212-7339 | |
(720) 328-4990 | |
(720) 328-4994 |
Full Name | Fangman & Ivey Oral And Facial Surgery Pllc |
---|---|
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 5600 W 44th Ave Ste 100, Denver, Colorado |
Authorized Official Name and Position | Brian John Fangman (PRESIDENT/CEO) |
Authorized Official Contact | 7203284990 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Fangman & Ivey Oral And Facial Surgery Pllc 5600 W 44th Ave Ste 100 Denver CO 80212-7339 Ph: (720) 328-4990 | Fangman & Ivey Oral And Facial Surgery Pllc 5600 W 44th Ave Ste 100 Denver CO 80212-7339 Ph: (720) 328-4990 |
NPI Number | 1023604535 |
---|---|
Provider Enumeration Date | 12/18/2020 |
Last Update Date | 12/18/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023604535 | NPI | - | NPPES |
1013358985 | Other | TX | INDIVIDUAL NPI |
1609027556 | Other | NY | INDIVIDUAL NPI |
1952791964 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
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