| NPI | 1720485808 |
|---|---|
| Doing Business As | GLAMDERM |
| Entity Type | Organization |
| Authorized Contact | LIAN A MACK Owner 917-912-3615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 245368) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |