Arizona Skin And Laser Therapy Institute, Ltd
Dermatology in Phoenix, AZ. Organization (NPI-2).
NPI number1770519019
StatusActive
Last updated in NPPESJan 11, 2008
Details
- NPI
- 1770519019
- Entity type
- Organization (NPI-2)
- Legal business name
- Arizona Skin And Laser Therapy Institute, Ltd
- Organization subpart
- No
- Enumeration date
- Jun 25, 2006
- Last updated
- Jan 11, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Practice location
4232 E Cactus RdSuite 100
Phoenix, AZ 85032-7602
Phone 602-996-3050 · Fax 602-494-0481
Mailing address
2224 W Northern AveD 300
Phoenix, AZ 85021-4928
Phone 602-277-1449 · Fax 602-277-9984
Authorized official
Neil P Superfon
Owner/Physician
6022771449
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