Advanced Dermatology Care Medical Cosmetic and Surgery PA
Advanced Dermatology Care Medical Cosmetic and Surgery PA provides Dermatology Physician services in Forest Lake, Minnesota. Licensed in Minnesota. Registered with an NPI since 2008.
- Licensed in
- MN
- In the registry since
- 2008
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
25 Lake St N Ste 200Forest Lake, MN 55025-2535 Not confirmed with CMS for 16 years — call before visiting
Phone: (651) 484-2724
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X · Licence 1376 (MN) |
|---|
Record details
| NPI number | 1912158031 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Olaf Rustad — Dermatologist · (651) 484-2724 |
| Other names | Advanced Dermatology Care |
| NPI enumerated | October 7, 2008 |
| Last updated in NPPES | January 11, 2010 |
| Mailing address | 4480 Centerville Rd, Saint Paul, MN 55127-3674 |