Organization
LAKES DERMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REHANA LEILA AHMED-SAUCEDO MD, PHD (DERMATOLOGIST, PRESIDENT)
(612) 387-4627
Entity
Organization
Contact information
Practice address
14305 SOUTHCROSS DR W, SUITE 110, BURNSVILLE, MN 55306-7009
(612) 387-4627
(612) 377-9713
Mailing address
2732 IRVING AVE S, SUITE 110, MINNEAPOLIS, MN 55408-1049
(612) 387-4627
(612) 377-9713
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
51837
MN
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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