| NPI | 1356124416 |
|---|---|
| Doing Business As | IDEAL DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | KEVIN JOHN MOTT Authorized Rep 303-569-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |