Organization
DERMATOLOGY & AESTHETIC CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A DICKERSON MD (OWNER)
(937) 436-1117
Entity
Organization
Contact information
Practice address
1299 E ALEX BELL RD, CENTERVILLE, OH 45459-2658
(937) 436-1117
(937) 436-9576
Mailing address
1299 E ALEX BELL RD, CENTERVILLE, OH 45459-2658
(937) 436-1117
(937) 436-9576
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055983
—
OH
Enumeration date
05/18/2011
Last updated
10/27/2014
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