Lakes Dermatology, PA

NPI #1962871608 in Burnsville, Minnesota

Provider Information

NPI Number: 1962871608
Entity Type: Organization
Organization Name: Lakes Dermatology, PA
Primary Specialty: Dermatology
Enumeration Date: Sep 23, 2015
Last Updated: Sep 23, 2015

Practice Location

Address: 14305 SOUTHCROSS DR W
Address 2: SUITE 110
City: Burnsville
State: Minnesota
ZIP Code: 55306-7009
Phone: (612) 387-4627

Authorized Official

Name: DR. REHANA LEILA AHMED-SAUCEDO, MD, PHD
Title: DERMATOLOGIST, PRESIDENT
Phone: (612) 387-4627

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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