NPI | 1013557933 |
---|---|
Doing Business As | ADVANCED DERMATOLOGY & SKIN SURGERY |
Entity Type | Organization |
Authorized Contact | BRET S BLACKHART Owner 775-336-3624 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
207NS0135X Dermatology, Procedural Dermatology | |
Enumeration Date | 2020-01-08 |
Last Update Date | 2020-01-08 |