NPI | 1376915629 |
---|---|
Doing Business As | PREMIER DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | BETSY J WERNLI President 920-482-0671 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
207NS0135X Dermatology Procedural Dermatology | |
Enumeration Date | 2015-10-27 |
Last Update Date | 2018-05-17 |