Provider Demographics
NPI:1093937625
Name:AURORA PLASTIC SURGERY, P.C.
Entity Type:Organization
Organization Name:AURORA PLASTIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLLENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-695-4369
Mailing Address - Street 1:1411 S. POTOMAC STREET
Mailing Address - Street 2:SUITE 310
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:303-695-4369
Mailing Address - Fax:303-695-4649
Practice Address - Street 1:1411 S. POTOMAC STREET
Practice Address - Street 2:SUITE 310
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:303-695-4369
Practice Address - Fax:303-695-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44189541Medicaid
C487128Medicare PIN