Organization
CENTENNIAL DERMATOLOGY AND SKIN CANCER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TAHERI MD (PRESIDENT)
(702) 432-3800
Entity
Organization
Contact information
Practice address
5500 PAINTED MIRAGE ROAD, SUITE 100, LAS VEGAS, NV 89149
(702) 432-3800
Mailing address
PO BOX 496084, REDDING, CA 96049-6084
(702) 432-3800
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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