Provider Demographics
NPI:1811590433
Name:ADVANCED DERMATOLOGY SKIN CANCER & LASER SURGERY CENTER P.C.
Entity Type:Organization
Organization Name:ADVANCED DERMATOLOGY SKIN CANCER & LASER SURGERY CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OSTEOPATHIC MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:PAPADEAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-638-8611
Mailing Address - Street 1:3464 S. WILLOW STREET
Mailing Address - Street 2:SUITE 194
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:303-755-0404
Practice Address - Street 1:2352 MEADOWS BLVD
Practice Address - Street 2:STE 220
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8416
Practice Address - Country:US
Practice Address - Phone:303-493-1910
Practice Address - Fax:303-493-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty