| NPI | 1053994004 |
|---|---|
| Doing Business As | THE DERM, A FOREFRONT DERMATOLOGY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DENISE L ANGER Sr. Director, Provider Enrollment 920-663-9022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2021-04-28 |