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General NPI Number Information
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NPI Number | 1407363971
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Entity Type | Organization
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Legal Business Name | PURE DERMATOLOGY PLLC
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 501 S CHERRY ST STE 310
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City | GLENDALE
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State | CO
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Zip | 80246-1325
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Country | US
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Telephone | 303-333-7873
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Fax |
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Provider Business Mailing Address
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Address Line | 501 S CHERRY ST STE 310
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City | GLENDALE
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State | CO
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Zip | 80246-1325
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Country | US
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Telephone | 303-333-7873
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. CARRIE ELIZABETH CERA HILL
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Credential | MD
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Telephone | 303-725-7592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 48901
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License Number State | CO
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