Mod Dermatology PC

NPI #1982105425 in Omaha, Nebraska

Provider Information

NPI Number: 1982105425
Entity Type: Organization
Organization Name: Mod Dermatology PC
Primary Specialty: Specialist
Enumeration Date: Feb 21, 2018
Last Updated: Jan 20, 2023

Practice Location

Address: 16910 FRANCES ST
City: Omaha
State: Nebraska
ZIP Code: 68130-2398
Phone: (402) 505-8777

Authorized Official

Name: ALAINA PATERA, MBA
Title: PRACTICE MANAGER
Phone: (402) 505-8777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary
Dermatology	207N00000X
Physician Assistant	363A00000X

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