| NPI | 1376576454 |
|---|---|
| Doing Business As | SKIN SMART DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | TOM SIDGMORE Practice Administrator 941-308-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME89181) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2019-10-31 |