Organization
ADVANCED DERMATOLOGY AND LASER CENTER P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEN M TREEN MD (PRESIDENT/OWNER)
(864) 295-3376
Entity
Organization
Contact information
Practice address
107 CLAIR DR, PIEDMONT, SC 29673-7771
(864) 295-3376
(864) 295-9117
Mailing address
107 CLAIR DR, PIEDMONT, SC 29673-7771
(864) 295-3376
(864) 295-9117
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
13943
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139433
—
SC
01
—
1457466971
NPI INDIVIDUAL
SC
Enumeration date
09/24/2007
Last updated
09/07/2011
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