# DERMATOLOGY SURGERY CENTER, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215985601
- **Authorized official:** TERESA KAY DILTS (ADMINISTRATOR)
- **Authorized official phone:** (402) 330-4555

## Contact information

- **Practice address:** 11623 ARBOR ST, SUITE 102, OMAHA, NE 68144-2981
- **Practice address phone:** (402) 330-4555
- **Practice address fax:** (402) 330-4626
- **Mailing address:** 11623 ARBOR ST, SUITE 102, OMAHA, NE 68144-2981
- **Mailing address phone:** (402) 330-4555
- **Mailing address fax:** (402) 330-4626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASC005 | NE | Yes |

## Other

- **Enumeration date:** 05/05/2006
- **Last updated:** 07/11/2011