Main Street Dermatology, Pllc

LBN: Main Street Dermatology, Pllc
Main Street Dermatology, Pllc is an health care organization with primary practice located at 5885 S Main St Ste 1 , Clarkston MI 48346-2981. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Main Street Dermatology, Pllc can be contacted via phone (248) 238-8059, or through Gardner, Kenzie via phone (614) 507-3765.

Contact Information

Primary practice address
5885 S Main St Ste 1 Clarkston MI 48346-2981
Phone: (248) 238-8059
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gardner, Kenzie Nurse Practitioner (NP)
Phone: (614) 507-3765

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1881371946
LBN Legal business name Main Street Dermatology, Pllc
DBA Doing business as
Authorized official Gardner, Kenzie Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2023
Last updated Aug 3rd, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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