NPI | 1912158031 |
---|---|
Doing Business As | ADVANCED DERMATOLOGY CARE |
Entity Type | Organization |
Authorized Contact | OLAF J RUSTAD Dermatologist 651-484-2724 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MN 1376) |
Enumeration Date | 2008-10-07 |
Last Update Date | 2010-01-11 |