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General NPI Number Information
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NPI Number | 1841892767
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Entity Type | Organization
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Legal Business Name | ADVANCED DERMATOLOGY SKIN CANCER & LASER SURGERY CENTER P.C.
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 710 SUMMIT BLVD SUITE 102
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City | FRISCO
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State | CO
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Zip | 80443-0000
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Country | US
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Telephone | 970-668-9650
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Fax | 970-668-9654
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Provider Business Mailing Address
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Address Line | 3464 S. WILLOW STREET SUITE 194
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City | DENVER
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State | CO
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Zip | 80231-4531
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Country | US
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Telephone | 303-755-2900
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Fax | 303-755-0404
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Authorized Official
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Title or Position | DIRECTOR OF OSTEOPATHIC MEDECINE
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Name | GREGORY G. PAPADEAS
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Credential | DO
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Telephone | 303-368-8611
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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 |
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License Number State |
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