Lake Loveland Dermatology PC

NPI #1265033138 in Estes Park, Colorado

Provider Information

NPI Number: 1265033138
Entity Type: Organization
Organization Name: Lake Loveland Dermatology PC
Primary Specialty: Dermatology
Enumeration Date: Nov 5, 2020
Last Updated: Jan 19, 2021

Practice Location

Address: 555 PROSPECT AVE
City: Estes Park
State: Colorado
ZIP Code: 80517-6312
Phone: (970) 667-3119

Authorized Official

Name: KEVIN JOHN MOTT
Title: OWNER
Phone: (303) 569-7700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery	207ND0101X
Dermatology - Dermatopathology — Dermatopathology	207ND0900X
Dermatology - Procedural Dermatology — Procedural Dermatology	207NS0135X
Dermatology	207N00000X	Primary

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