| NPI | 1376584839 |
|---|---|
| Doing Business As | SVPN DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | JOHN C KINNA Executive Director 406-237-3061 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MT 13258) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: MT 9717) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2013-02-26 |