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General NPI Number Information
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NPI Number | 1285990127
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Entity Type | Organization
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Legal Business Name | DERMATIQUE, LTD
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 04/04/2012
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Provider Practice Location Address
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Address Line | 6900 E CAMELBACK RD CAMELBACK TOWER, SUITE 900
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2431
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Country | US
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Telephone | 480-619-5540
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Fax | 888-453-1518
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Provider Business Mailing Address
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Address Line | 6900 E CAMELBACK RD CAMELBACK TOWER, SUITE 900
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2431
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Country | US
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Telephone |
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Fax | 888-453-1518
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM PATRICK DAVEY
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Credential | MD
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Telephone | 480-619-5540
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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 |
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License Number State |
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