Organization
ALLIANCE DERMATOLOGY & MOHS CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G BOTTIGLIONE MD (OWNER)
(602) 971-0268
Entity
Organization
Contact information
Practice address
4045 E BELL RD, 147, PHOENIX, AZ 85032
(602) 971-0268
(602) 971-1556
Mailing address
4045 E BELL RD, 147, PHOENIX, AZ 85032
(602) 971-0268
(602) 971-1556
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z74888
PTAN
AZ
Enumeration date
08/02/2006
Last updated
10/20/2011
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