Provider Demographics
NPI:1841975992
Name:CENTENNIAL SURGICAL SPECIALISTS PC
Entity type:Organization
Organization Name:CENTENNIAL SURGICAL SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:HAEMAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:NOORI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:720-475-4772
Mailing Address - Street 1:26 W DRY CREEK CIR STE 740
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8066
Mailing Address - Country:US
Mailing Address - Phone:303-224-0500
Mailing Address - Fax:303-224-0606
Practice Address - Street 1:26 W DRY CREEK CIR STE 740
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8066
Practice Address - Country:US
Practice Address - Phone:303-224-0500
Practice Address - Fax:303-224-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty