| NPI | 1326646845 |
|---|---|
| Doing Business As | ST. DOMINIC DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | DANIELLE STUART Credentialing Specialist 601-200-4880 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2021-05-26 |