Dermatology Center for Children & Young Adults PA

NPI #1053417055 in Eagan, Minnesota

Provider Information

NPI Number
1053417055
Entity Type
Organization
Organization Name
Dermatology Center for Children & Young Adults PA
Primary Specialty
Dermatology - Pediatric Dermatology
Enumeration Date
Sep 16, 2006
Last Updated
Apr 20, 2008

Practice Location

Address
2795 PILOT KNOB RD
Address 2
SUITE 300
City
Eagan
ZIP Code
55121-1176
Phone
(651) 379-9999

Authorized Official

Name
KENNETH E BLOOM, MD
Title
PRESIDENT
Phone
(651) 379-9999

Specialties & Taxonomy Codes

Specialty
Dermatology - Pediatric DermatologyPediatric Dermatology

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