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Organization

HOUSE OF DERMATOLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAVI R PATEL MD (OWNER)
(706) 676-4836
Entity
Organization

Contact information

Practice address
55 ROSWELL ST STE 110, ALPHARETTA, GA 30009-1979
(404) 721-2418
Mailing address
5144 ARTEMESIA LN, DALLAS, TX 75209-6242
(706) 676-4836

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician

Other

Enumeration date
03/30/2022
Last updated
03/30/2022
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