Organization
DALTON DERMATOLOGY & DAY SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY E. COLE M.D. (OWNER/M.D.)
(706) 226-3311
Entity
Organization
Contact information
Practice address
1108 PROFESSIONAL BLVD, DALTON, GA 30720-2588
(706) 226-3311
Mailing address
1108 PROFESSIONAL BLVD, DALTON, GA 30720-2588
(706) 226-3311
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
065349
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
GA
Enumeration date
06/11/2013
Last updated
06/11/2013
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