| NPI | 1316011398 |
|---|---|
| Doing Business As | BAY SHORE DERMATOLOGY & LASER SURGERY CENTER, PC |
| Entity Type | Organization |
| Authorized Contact | ROBERT CLARK President 251-928-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2023-10-26 |