Organization
OMNI DERMATOLOGY TEMPE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW JOSEPH RACETTE D.O. (PRESIDENT)
(602) 559-9961
Entity
Organization
Contact information
Practice address
4515 S MCCLINTOCK DR, STE 101, TEMPE, AZ 85282-7376
(602) 559-5470
(602) 559-5471
Mailing address
4840 E INDIAN SCHOOL RD, STE 102, PHOENIX, AZ 85018-5500
(602) 559-9961
(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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