| NPI | 1013155480 |
|---|---|
| Doing Business As | CENTER FOR DERMATOLOGY & COSMETIC LASER SURGERY |
| Entity Type | Organization |
| Authorized Contact | BRAD JOHNSON Manager 972-985-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX L4702) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2012-08-14 |