Organization
ESSENTIAL DERMATOLOGY AND COSMETIC SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN VAN WILKES D.O. (OWNER/CEO)
(806) 241-4195
Entity
Organization
Contact information
Practice address
1105 SANTA FE DRIVE, STE 105, WEATHERFORD, TX 76086-5852
(806) 241-4195
Mailing address
1105 SANTA FE DRIVE, STE 105, WEATHERFORD, TX 76086-5852
(806) 241-4195
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/30/2015
Last updated
03/28/2015
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