Basic Information
| Provider Information | |||||||||
| NPI: | 1336409705 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACCENT DERMATOLOGY AND LASER INSTITUTE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 INDIANA ST | ||||||||
| Address2: | SUITE #390 | ||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804015027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034639600 | ||||||||
| FaxNumber: | 3034039919 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 INDIANA ST | ||||||||
| Address2: | SUITE #390 | ||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804015027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034639600 | ||||||||
| FaxNumber: | 3034039919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2012 | ||||||||
| LastUpdateDate: | 05/20/2012 | ||||||||
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| AuthorizedOfficialLastName: | SAWADA | ||||||||
| AuthorizedOfficialFirstName: | KATHLEEN | ||||||||
| AuthorizedOfficialMiddleName: | YUMI | ||||||||
| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 3034639600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 25124 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.