ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA

FOREST LAKE, MN
NPI1912158031
Doing Business AsADVANCED DERMATOLOGY CARE
Entity TypeOrganization
Authorized ContactOLAF J RUSTAD
Dermatologist
651-484-2724
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
(Licence: MN  1376)
Enumeration Date2008-10-07
Last Update Date2010-01-11
Business Address
ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA
25 LAKE ST N SUITE 200
FOREST LAKE, MN 55025-2535
Phone number: 651-484-2724
Mailing Address
ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA
4480 CENTERVILLE RD
SAINT PAUL, MN 55127-3674
Phone number: 641-484-2724