Provider Demographics
NPI:1356867873
Name:ASPEN SURGICAL ARTS-IMPLANTS AND ORAL MAXILLOFACIAL SURGERY
Entity Type:Organization
Organization Name:ASPEN SURGICAL ARTS-IMPLANTS AND ORAL MAXILLOFACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:PLEVNIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-840-2300
Mailing Address - Street 1:19700 E PARKER SQUARE DR STE B4
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7301
Mailing Address - Country:US
Mailing Address - Phone:303-840-2300
Mailing Address - Fax:303-840-8610
Practice Address - Street 1:19700 E PARKER SQUARE DR STE B4
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7301
Practice Address - Country:US
Practice Address - Phone:303-840-2300
Practice Address - Fax:303-840-8610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty