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Organization
ADVANCED DERMATOLOGY CARE A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
ADVANCED DERMATOLOGY CARE A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORETTA PYLANT GREMILLION M.D. (OWNER)
(318) 323-8799
Entity
Organization
Contact information
Practice address
2409 BROADMOOR BLVD, MONROE, LA 71201-2964
(318) 323-8799
(318) 323-8815
Mailing address
1868 FORSYTHE AVE STE 335, MONROE, LA 71201-3540
(318) 323-8799
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
026501
LA
Other
Enumeration date
04/08/2011
Last updated
07/12/2018
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