Organization
OMNI DERMATOLOGY ESTRELLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW JOSEPH RACETTE D.O. (PRESIDENT)
(602) 954-3919
Entity
Organization
Contact information
Practice address
9305 W THOMAS RD, STE 350, PHOENIX, AZ 85037-3328
(623) 478-8000
(623) 478-8003
Mailing address
4840 E INDIAN SCHOOL RD, STE 102, PHOENIX, AZ 85018-5500
(602) 954-3919
(602) 954-3670
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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