# PINNACLE DERMATOLOGY, S.C.

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

## Provider details

- **NPI number:** 1720814429
- **Authorized official:** JOSE LUIS RIOS MD (VICE PRESIDENT)
- **Authorized official phone:** (815) 744-8554

## Contact information

- **Practice address:** 935 WAYZATA BLVD E STE 200, WAYZATA, MN 55391-2513
- **Practice address phone:** (763) 220-8030
- **Mailing address:** PO BOX 734240, CHICAGO, IL 60673-4240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | Yes |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | — | NULL | — |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 09/10/2024
- **Last updated:** 09/26/2024