| NPI | 1285138032 |
|---|---|
| Doing Business As | SAINTS DERMATOLOGY CENTER OF EXCELLENCE MUSTANG |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Insurance Credentialing Specialist 405-272-7452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |