Centennial Dermatology and Skin Cancer INC

NPI #1902160252 in Las Vegas, Nevada

Provider Information

NPI Number: 1902160252
Entity Type: Organization
Organization Name: Centennial Dermatology and Skin Cancer INC
Primary Specialty: Dermatology
Enumeration Date: Jul 2, 2012
Last Updated: Jul 2, 2012

Practice Location

Address: 5550 PAINTED MIRAGE RD
Address 2: SUITE 110
City: Las Vegas
State: Nevada
ZIP Code: 89149-4581
Phone: (702) 432-3800

Authorized Official

Name: DANIEL TAHERI, MD
Title: PRESIDENT
Phone: (702) 432-3800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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