Provider Demographics
NPI:1093757627
Name:DYR SURGASSIST INC
Entity Type:Organization
Organization Name:DYR SURGASSIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBEN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DATKHAEV
Authorized Official - Suffix:
Authorized Official - Credentials:SA
Authorized Official - Phone:720-540-7155
Mailing Address - Street 1:3464 S WILLOW ST
Mailing Address - Street 2:SUITE 154
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:303-755-0404
Practice Address - Street 1:3715 W 95TH PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2603
Practice Address - Country:US
Practice Address - Phone:720-540-7155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty