# DAKOTA RIDGE FAMILY MEDICINE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720043888
- **Authorized official:** VICKIE E MCCAY (OFFICE MANAGER)
- **Authorized official phone:** (303) 443-2544

## Contact information

- **Practice address:** 2995 BASELINE RD, SUITE 210, BOULDER, CO 80303-2318
- **Practice address phone:** (303) 443-2544
- **Practice address fax:** (303) 443-6476
- **Mailing address:** 2995 BASELINE RD, SUITE 210, BOULDER, CO 80303-2318
- **Mailing address phone:** (303) 443-2544
- **Mailing address fax:** (303) 443-6476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 10/25/2007