NPI | 1366086597 |
---|---|
Former Legal Business Name | PC DERMATOLOGY PLLC |
Entity Type | Organization |
Authorized Contact | BISHR AL DABAGH Owner 704-230-1302 |
Organization Subpart ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
Additional Taxonomies | 207N00000X Dermatology |
207NS0135X Dermatology, Procedural Dermatology | |
Enumeration Date | 2019-10-31 |
Last Update Date | 2023-06-04 |