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1073614558
ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA
WHITE BEAR LAKE, MN
NPI
1073614558
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Entity Type
Organization
Authorized Contact
OLAF J RUSTAD
Owner
651-484-2724
Organization Subpart ?
Yes
Primary Taxonomy
207N00000X Dermatology
Enumeration Date
2006-09-26
Last Update Date
2018-11-16
Business Address
ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA
4480 CENTERVILLE RD
WHITE BEAR LAKE, MN 55127-3674
Phone number: 651-484-2724
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Mailing Address
ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA
4480 CENTERVILLE RD
WHITE BEAR LAKE, MN 55127-3674
Phone number: 651-484-2724
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