NPI | 1801003496 |
---|---|
Doing Business As | ASSOCIATED DERMATOLOGIST PA |
Entity Type | Organization |
Authorized Contact | JOHN C LONG Owner 386-672-3111 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME68137) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2008-04-20 |