Great Lakes Dermatology

NPI #1558576322 in Kenosha, Wisconsin

Provider Information

NPI Number
1558576322
Entity Type
Organization
Organization Name
Great Lakes Dermatology
Primary Specialty
Dermatology - Procedural Dermatology
Enumeration Date
May 14, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
3601 30TH AVE
Address 2
SUITE 210
ZIP Code
53144-1695
Phone
(262) 658-2594

Authorized Official

Name
CATHY DEAN
Title
ADMINISTRATOR
Phone
(800) 485-8640

Specialties & Taxonomy Codes

Specialty
Dermatology - Procedural DermatologyProcedural Dermatology

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