Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1710952882 |
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| LBN Legal business name | ADVANCED DERMATOLOGY AND SKIN SURGERY, PLLC | ||||||||||||
| Authorized official | JOEL SEARS - (MEDICAL DIRECTOR) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 02/21/2006 | ||||||||||||
| Last updated | 04/26/2018 - About 8 years ago | ||||||||||||
| Identifiers |
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