Organization
FOREFRONT DERMATOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETSY J WERNLI MD (PRESIDENT)
(920) 482-0671
Entity
Organization
Contact information
Practice address
3935 N LIGHTNING DR, APPLETON, WI 54913
(920) 968-1790
(920) 968-1794
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21325000
—
WI
Enumeration date
01/23/2007
Last updated
05/17/2018
Update your record
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