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 |