| NPI | 1417934001 |
|---|---|
| Former Legal Business Name | DERMATOLOGIC LASER CENTER, PLLC |
| Entity Type | Organization |
| Authorized Contact | DENISE HUDSON Office Manager 704-376-9849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2024-04-16 |