Organization
THE GALLERY OF DERMATOLOGY AND ADVANCED AESTHETICS
Active
Other names
The Gallery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRI ELIZABETH DAVIS-FONTENOT MD (OWNER)
(337) 564-7546
Entity
Organization
Contact information
Practice address
1936 SOUTHWOOD DR, LAKE CHARLES, LA 70605-4131
(337) 564-7546
Mailing address
1936 SOUTHWOOD DR, LAKE CHARLES, LA 70605-4131
(337) 564-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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