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General NPI Number Information
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NPI Number | 1629032404
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 220 SOUTHBROOK DR
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City | WATERLOO
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State | IA
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Zip | 50702-5802
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Country | US
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Telephone | 319-236-3444
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Fax | 319-236-0257
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Provider Business Mailing Address
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Address Line | 3812 PHEASANT LN
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City | WATERLOO
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State | IA
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Zip | 50701-5200
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Country | US
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Telephone | 319-236-3444
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Fax | 319-236-0257
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRYAN DAVID SANDS
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Credential | DO
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Telephone | 319-236-3444
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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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