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Contact Information

DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA
2795 PILOT KNOB RD
SUITE 300
EAGAN, MN55121-1176
 Phone: 651-379-9999
 Fax: 651-379-9900
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Dermatology

207NP0225X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for DERMATOLOGY CENTER FOR CHILDREN YOUNG ADULTS PA · (Female)

NPI # 1053417055
Status Active
Credentials
Entity Individual
Enumeration date 09/16/2006
Last updated 04/20/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • ND Medicaid 013837
  • Other 2M741DE BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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