Organization
DERMATOLOGY PROFESSIONALS PA
Active
Parent organization
DERMATOLOGY PROFESSIONALS PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DERMATOLOGY PROFESSIONALS PA
Authorized official
MORGAN BURGSTALER (ADMINISTRATOR)
(218) 454-3065
Entity
Organization
Contact information
Practice address
15167 EDGEWOOD DR, SUITE 200, BAXTER, MN 56401-6946
(218) 454-7546
Mailing address
13359 ISLE DR, SUITE 3, BAXTER, MN 56425-2222
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
45453
MN
Other
Enumeration date
09/14/2012
Last updated
06/12/2024
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