Organization
LASER & DERMATOLOGIC SURGERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT RADLE BS HEALTHCARE ADMIN (PRACTICE MANAGER)
(314) 878-3839
Entity
Organization
Contact information
Practice address
1001 CHESTERFIELD PKWY E, SUITE 101, CHESTERFIELD, MO 63017-2041
(314) 878-3839
(314) 878-6575
Mailing address
1001 CHESTERFIELD PKWY E, SUITE 101, CHESTERFIELD, MO 63017-2041
(314) 878-3839
(314) 878-6575
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
R6H14
MO
Other
Enumeration date
02/27/2006
Last updated
02/13/2012
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