Organization
DESERT SKY DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE BERGER (PRACTICE MANAGER)
(480) 855-0085
Entity
Organization
Contact information
Practice address
1688 E. BOSTON ST., SUITE #101, GILBERT, AZ 85295-6220
(480) 855-0085
(480) 855-0086
Mailing address
1688 E. BOSTON ST., SUITE #101, GILBERT, AZ 85295-6220
(480) 855-0085
(480) 855-0086
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
45370
AZ
207ND0900X
Dermatopathology Physician
45370
AZ
207NS0135X
Procedural Dermatology Physician
29461
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
757618
—
AZ
Enumeration date
04/30/2012
Last updated
03/07/2024
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