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General NPI Number Information
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NPI Number | 1154016665
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Entity Type | Organization
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Legal Business Name | CURT SAMLASKA LTD ACADEMIC DERMATOLOGY OF NEVADA
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 2839 SAINT ROSE PKWY STE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4849
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Country | US
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Telephone | 702-837-8988
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Fax | 702-990-5269
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Provider Business Mailing Address
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Address Line | 2839 SAINT ROSE PKWY STE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4849
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Country | US
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Telephone | 702-837-8988
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Fax | 702-990-5269
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Authorized Official
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Title or Position | CREDENTIAL AGENT
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Name | MRS. KERRI LOOMIS
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Credential |
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Telephone | 702-463-1038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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