| NPI | 1114950375 |
|---|---|
| Other Name | ADVANCED DERMATOLOGY AND SKIN RENEWAL CENTER |
| Entity Type | Organization |
| Authorized Contact | J SEMMES MICKELWAIT Owner 360-424-4186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |