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
7040 N PORT WASHINGTON RD, SUITE 404, GLENDALE, WI 53217
(414) 355-2405
(414) 355-6460
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(866) 630-9882
(920) 683-9882
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
03/27/2012
Last updated
05/17/2018
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