Integrated Dermatology of Boulder Creek, LLC
Integrated Dermatology of Boulder Creek, LLC is a Dermatology Physician in Superior, Colorado. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 3
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
400 S McCaslin Blvd Ste 100Superior, CO 80027-9701
Phone: (303) 666-5261
Fax: (303) 604-6062
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X |
|---|---|
| MOHS-Micrographic Surgery Physician | Taxonomy 207ND0101X |
| Physician Assistant | Taxonomy 363A00000X |
Record details
| NPI number | 1568033066 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | David Fuentes — Authorized · (561) 314-2000 |
| NPI enumerated | July 6, 2021 |
| Last updated in NPPES | July 6, 2021 |
| Certification date | July 6, 2021 |
| Mailing address | 4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450 |