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General NPI Number Information
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NPI Number | 1770520587
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Entity Type | Organization
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Legal Business Name | AESTHETIC SPECIALTY CENTRE, PC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 1825 OLD ALABAMA RD SUITE 201
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City | ROSWELL
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State | GA
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Zip | 30076-2258
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Country | US
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Telephone | 770-393-9000
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Fax | 770-393-9006
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Provider Business Mailing Address
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Address Line | 1825 OLD ALABAMA RD SUITE 201
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City | ROSWELL
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State | GA
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Zip | 30076-2258
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Country | US
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Telephone | 770-393-9000
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Fax | 770-393-9006
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC EAN YUNE
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Credential | MD
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Telephone | 770-393-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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