| NPI | 1518257229 |
|---|---|
| Doing Business As | ADVANCED DERMATOLOGY AND COSMETIC SURGERY |
| Entity Type | Organization |
| Authorized Contact | NEFRITA LOGAN Provider Service Rep 4017-875-2080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |