Advanced Dermatology Care Medical Cosmetic and Surgery PA

NPI #1144486978 in Stillwater, Minnesota

Provider Information

NPI Number: 1144486978
Entity Type: Organization
Organization Name: Advanced Dermatology Care Medical Cosmetic and Surgery PA
Primary Specialty: Dermatology
Enumeration Date: Jul 31, 2008
Last Updated: Mar 11, 2024

Practice Location

Address: 14130 60TH ST N
City: Stillwater
State: Minnesota
ZIP Code: 55082-6354
Phone: (651) 484-2724

Authorized Official

Name: OLAF JONATHAN RUSTAD, MD
Title: DERMATOLOGIST PRESIDENT
Phone: (651) 484-2724

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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