National Provider Identifier Database

ALTITUDE ORAL AND FACIAL COSMETIC SURGERY LONE TREE PLLC
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

ALTITUDE ORAL AND FACIAL COSMETIC SURGERY LONE TREE, PLLC
10375 PARK MEADOWS DR STE 150
LONE TREE, CO80124-6755
Phone: 303-792-2828
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for ALTITUDE ORAL AND FACIAL COSMETIC SURGERY LONE TREE, PLLC

NPI Number 1770091720
Legal business name
LBN
ALTITUDE ORAL AND FACIAL COSMETIC SURGERY LONE TREE, PLLC
Authorized official BRAIN FANGMAN - (PRESIDENT CEO)
Entity Organization
Organization subpart Yes
Enumeration date 01/11/2018
Last updated 04/11/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • CO License #: 0202239
  • CO Medicaid: 1952791964
  • NY Other: 1609027556 INDIVIDUAL NPI

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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