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Mountain Dermatology Specialists, P.C.

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Company Details

Name: Mountain Dermatology Specialists, P.C.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 28 Nov 2011 (14 years ago)
Entity Number: 20111653894
ZIP code: 81632
County: Eagle County
Place of Formation: COLORADO
Principal Address: 105 Edwards Village Blvd G211 Edwards CO 81632 US
Mailing Address: PO Box 2606 Edwards CO 81632 US

National Provider Identifier

NPI Number:
1790053213

Authorized Person:

Name:
JEAN L URQUHART
Role:
PHYSICIAN OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
No
Selected Taxonomy:
207ND0900X - Dermatopathology Physician
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
8885052650

Form 5500 Series

Employer Identification Number (EIN):
453928507
Plan Year:
2023
Number Of Participants:
12
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
6
Sponsors Telephone Number:

Transaction History

Transaction ID Type Date Effective date Name Comment
20248096959 File Report 2024-10-14 2024-10-14 No data Principal address changed
20238125021 File Report 2023-10-24 2023-10-24 No data Principal address changed
20221973568 File Report 2022-10-06 2022-10-06 No data Principal address changed, Change in registered agent information
20211924610 File Report 2021-10-05 2021-10-05 No data No data
20201883131 File Report 2020-10-13 2020-10-13 No data No data

USAspending Awards / Financial Assistance

Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
116400.00
Total Face Value Of Loan:
116400.00

Paycheck Protection Program

Jobs Reported:
10
Initial Approval Amount:
$116,400
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$116,400
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$116,989.97
Servicing Lender:
Customers Bank
Use of Proceeds:
Payroll: $116,400

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Date of last update: 14 Jul 2025

Sources: Colorado's Secretary of State