Provider Demographics
NPI:1952677973
Name:COLORADO SURGICAL ARTS
Entity Type:Organization
Organization Name:COLORADO SURGICAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD DDS
Authorized Official - Phone:303-806-8600
Mailing Address - Street 1:2900 S. PEORIA STREET
Mailing Address - Street 2:UNIT D
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014
Mailing Address - Country:US
Mailing Address - Phone:303-755-3353
Mailing Address - Fax:303-755-3437
Practice Address - Street 1:2900 S. PEORIA STREET
Practice Address - Street 2:UNIT D
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014
Practice Address - Country:US
Practice Address - Phone:303-755-3353
Practice Address - Fax:303-755-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10547204E00000X
CO100972204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty