| NPI | 1578694238 |
|---|---|
| Other Name | DERMATOLOGY & LASER CENTER OF CANYON COUNTY |
| Entity Type | Organization |
| Authorized Contact | GAVIN R POWELL President 208-467-3006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID M7519) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-10-15 |