Organization
COSMETIC DERMATOLOGY BY SEAN DEGNAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY R ESTRADA (OFFICE MANAGER)
(775) 588-3300
Entity
Organization
Contact information
Practice address
165 HWY 50, SUITE 100, STATELINE, NV 89449-5757
(775) 588-3300
(775) 588-3353
Mailing address
PO BOX 5757, STATELINE, NV 89449-5757
(775) 588-3300
(775) 588-3353
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
5488
NV
Other
Enumeration date
07/13/2007
Last updated
11/28/2012
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