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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
2806 RIVERVIEW DR, GREEN BAY, WI 54313
(920) 498-7546
(920) 569-4129
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207NS0135X
Procedural Dermatology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21288900
WI
Enumeration date
05/23/2006
Last updated
05/17/2018
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