Organization
DERMATOLOGY ASSOCIATES, P.C.
Active
Other names
Dermatology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETH A HONL (PHYSICIAN)
(701) 478-7747
Entity
Organization
Contact information
Practice address
4133 30TH AVE S STE 101, FARGO, ND 58104
(701) 478-7747
(701) 478-7748
Mailing address
4133 30TH AVE S STE 101, FARGO, ND 58104
(701) 478-7747
(701) 478-7748
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026092400
—
MN
01
—
06218001
BLUE SHIELD OF ND
ND
05
—
12984
—
ND
01
—
246K7DE
BLUE SHIELD OF MN
MN
Enumeration date
12/29/2007
Last updated
01/23/2019
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