| NPI | 1770275323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA K DYER Practice Administrator 719-574-0310 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-23 |