Great Lakes Dermatology
NPI #1205041688 in Pleasant Prairie, Wisconsin
Provider Information
- NPI Number
- 1205041688
- Entity Type
- Organization
- Organization Name
- Great Lakes Dermatology
- Primary Specialty
- Dermatology - Procedural Dermatology
- Enumeration Date
- May 11, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 9555 76TH ST
- Address 2
- SUITE 2600
- City
- Pleasant Prairie
- State
- Wisconsin
- ZIP Code
- 53158-1984
- Phone
- (800) 485-8640
Authorized Official
- Name
- CATHY DEAN
- Title
- ADMINISTRATOR
- Phone
- (800) 485-8640
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology - Procedural Dermatology — Procedural Dermatology |
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Organizations
| Provider Name | |
|---|---|
| Great Lakes Dermatology | AI Deep Dive |
| Great Lakes Dermatology | AI Deep Dive |
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