| NPI | 1174923221 |
|---|---|
| Doing Business As | LAKES DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | KATIE RUECKL Office Manager 702-869-6667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2020-10-16 |