Provider Demographics
NPI:1720569569
Name:DASTGEER SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:DASTGEER SURGICAL ASSOCIATES
Other - Org Name:DSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:WALID
Authorized Official - Last Name:DASTGEER
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:720-300-1208
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80038-0041
Mailing Address - Country:US
Mailing Address - Phone:720-300-1208
Mailing Address - Fax:303-410-6903
Practice Address - Street 1:200 EXEMPLA CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3370
Practice Address - Country:US
Practice Address - Phone:720-300-1208
Practice Address - Fax:303-410-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83266246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty