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 25 Lake St N Suite 200, Forest Lake MN 55025-2535. 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
25 Lake St N Suite 200 Forest Lake MN 55025-2535
Phone: (651) 484-2724
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Rustad, Olaf J Doctor of Medicine (MD)
Phone: (651) 484-2724

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 1376 Minnesota

Profile Details

NPI number 1912158031
LBN Legal business name Advanced Dermatology Care Medical Cosmetic And Surgery Pa
DBA Doing business as Advanced Dermatology Care
Authorized official Rustad, Olaf J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 7th, 2008
Last updated Jan 11th, 2010 - about 14 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 1912158031 NPPES
Minnesota Other C01783 GROUP LEGACY
Minnesota Other 070000195 GROUP LEGACY

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