DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC

Active Organization

Dermatology · LONGMONT, CO

Registration Details

NPI Number
1962164269
Provider Type
Organization
NPI Issued
Oct 13, 2021 (4.5228457738855 yrs)
Last Updated
Oct 13, 2021

Practice Information

Address
1715 IRON HORSE DR STE 104
LONGMONT, CO, 805019756
Browse CO providers · Browse ZIP 80501
Phone
9702862668
Fax
9702944954
Primary Specialty
Dermatology
207N00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.