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Organization

CLEMMENSEN, ADAMS, & TACK PSC

Active
Other names
Carson Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID ALAN TACK M.D. (PRESIDENT)
(775) 883-7811
Entity
Organization

Contact information

Practice address
1100 S CARSON ST, CARSON CITY, NV 89701-5232
(775) 883-7811
(775) 883-7871
Mailing address
1100 S CARSON ST, CARSON CITY, NV 89701-5232
(775) 883-7811
(775) 883-7871

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
02/15/2008
Last updated
01/22/2015
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