| NPI | 1730710229 |
|---|---|
| Former Legal Business Name | LASER RENEWAL PLLC |
| Entity Type | Organization |
| Authorized Contact | TAMRA A SCHUE Owner 701-388-6306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2021-12-07 |