Organization
EPIPHANY DERMATOLOGY OF MONTANA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (DIRECTOR/MANAGING EMPLOYEE)
(512) 960-5760
Entity
Organization
Contact information
Practice address
24 E BROADWAY ST, BUTTE, MT 59701-9334
(406) 723-7272
(406) 723-3328
Mailing address
7300 RANCH RD. 2222, BLDG 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
(512) 233-2711
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
12/07/2023
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