Organization
FOREFRONT DERMATOLOGY, S.C.
Active
Organization
FOREFRONT DERMATOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE L ANGER (SR. DIRECTOR, PROVIDER ENROLLMENT)
(920) 663-9022
Entity
Organization
Contact information
Practice address
2525 E PARIS AVE SE STE 100, GRAND RAPIDS, MI 49546-6191
(616) 678-2070
(616) 940-4578
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
07/05/2013
Last updated
04/21/2023
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