| NPI | 1306663570 | 
|---|---|
| Doing Business As | DBA ADVANCED DERMATOLOGY, A FOREFRONT DERMATOLOGY PRACTICE | 
| Entity Type | Organization | 
| Authorized Contact | BETSY J WERNLI President 920-482-0671 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207N00000X Dermatology | 
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery | 
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2024-09-20 | 
| Last Update Date | 2024-09-20 |