Advanced Dermatology Care

LBN: Advanced Dermatology Care Medical Cosmetic And Surgery Pa
Advanced Dermatology Care is an health care organization with primary practice located at 4480 Centerville Rd , White Bear Lake MN 55127-3674. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Advanced Dermatology Care Medical Cosmetic And Surgery Pa can be contacted via phone (651) 484-2724, or through Rustad, Olaf J via phone (651) 484-2724.

Contact Information

Primary practice address
4480 Centerville Rd White Bear Lake MN 55127-3674
Phone: (651) 484-2724
Fax: (651) 484-2723
Website:
Map and Directions
Authorized official contact:
Name: Rustad, Olaf J
Phone: (651) 484-2724

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1073614558
LBN Legal business name Advanced Dermatology Care Medical Cosmetic And Surgery Pa
DBA Doing business as Advanced Dermatology Care
Authorized official Rustad, Olaf J
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 26th, 2006
Last updated Nov 16th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073614558 NPPES
Minnesota Other C01783 PTAN

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