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General NPI Number Information
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NPI Number | 1194880104
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Entity Type | Organization
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Legal Business Name | ALL ABOUT AESTHETICS PC
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 8311 BANDFORD WAY SUITE 103
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City | RALEIGH
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State | NC
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Zip | 27615-2756
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Country | US
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Telephone | 919-845-0333
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Fax | 919-845-0773
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Provider Business Mailing Address
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Address Line | PO BOX 99717
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City | RALEIGH
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State | NC
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Zip | 27624-9717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEBORAH KESSLER HUDAK
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Credential | M.D.
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Telephone | 919-845-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 130069
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License Number State | NC
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