| Organization Name: | STEAMBOAT SPRINGS PLASTIC SURGERY CENTER |
| NPI Number: | 1073852372 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SCOTT M SULENTICH (PRESIDENT) |
| Mailing Address: | 940 Central Park Dr Ste 106 Steamboat Springs |
| State: | CO US |
| Postal Code: | 804878853 |
| Phone Number: | 9708794444 |
| Fax Number: | 9708710662 |
| NPI Enumeration Date: | 02/06/2013 |
| NPI Last Update Date: | 12/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |