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Contact Information

FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC
1555 MAIN ST UNIT A2
WINDSOR, CO80550-5999
 Phone: 720-328-4990
 Fax: 720-328-4994
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

NPI Profile & details for FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC

NPI Number 1750038089
LBN Legal business name FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC
Authorized official BRIAN FANGMAN - (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date 03/07/2022
Last updated 04/11/2022 - About 4 years ago
Identifiers
CO Medicaid 82781257
NY Other 1609027556 INDIVIDUAL NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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