Cosmetic Dermatology by Sean Degnan

Organization Active NPI Dermatology Physician · Stateline, NV

NPI 1144429820 · NPPES record last updated Nov 28, 2012

Key facts

NPI
1144429820
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
License
5488 (NV)
Legal business name
COSMETIC DERMATOLOGY BY SEAN DEGNAN
Practice address
165 Hwy 50
Suite 100
Stateline, NV 89449-5757
Phone
(775) 588-3300
Fax
(775) 588-3353
NPI assigned
Jul 13, 2007
Organization subpart
No

Authorized official

Name
Mrs. Mary R Estrada
Title
Office Manager
Phone
(775) 588-3300

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207N00000X 5488 NV Yes

Addresses

Primary practice location

165 Hwy 50
Suite 100
Stateline, NV 89449-5757

Mailing address

PO Box 5757
Stateline, NV 89449-5757
Phone (775) 588-3300

Other providers in Stateline, NV

All providers in Stateline, NV · Dermatology Physician in Nevada

Sources for this page

Verify at the official NPI Registry.