Healthcare Provider Details

I. General information

NPI: 1457578668
Provider Name (Legal Business Name): CENTER FOR PLASTIC AND AESTHETIC SURGERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 INVERNESS DR E SUITE 200
ENGLEWOOD CO
80112-5137
US

IV. Provider business mailing address

125 INVERNESS DR E SUITE 200
ENGLEWOOD CO
80112-5137
US

V. Phone/Fax

Practice location:
  • Phone: 303-708-8234
  • Fax: 303-649-9694
Mailing address:
  • Phone: 303-708-8234
  • Fax: 303-649-9694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBBIE KUBIK
Title or Position: PRACTICE ADMINISTRATOR
Credential: RN
Phone: 303-708-8234