Ct Derm PC

NPI #1902843485 in Fruitland, Idaho

Provider Information

NPI Number: 1902843485
Entity Type: Organization
Organization Name: Ct Derm PC
Primary Specialty: Dermatology
Enumeration Date: Jun 1, 2006
Last Updated: Mar 27, 2015

Practice Location

Address: 811 NW 12TH ST
City: Fruitland
State: Idaho
ZIP Code: 83619-2268
Phone: (208) 452-7450

Authorized Official

Name: CARL R THORNFELDT, MD
Title: OWNER
Phone: (208) 452-7450

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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