| NPI | 1881391670 |
|---|---|
| Former Legal Business Name | WHITE PEBBLE AESTHETIC DERMATOLOGY, LLC |
| Entity Type | Organization |
| Authorized Contact | JUNNAN CHEN Clinical Director 443-535-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |