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Mi Skin Center, Pllc

NPI Registration Record

Provider / OrganizationNPIDate Certified
MI SKIN CENTER, PLLC11145156082021-01-09
Entity TypeOrganization
Provider OrganizationMI SKIN CENTER, PLLC
Practice Office Address133 WEST MAIN STREET
SUITE 251
NORTHVILLE, MI US
Practice Office Telephone2489635915
Practice Office Fax2482784854
Mailing Address18561 STEEP HOLLOW CT
NORTHVILLE, MI 48168 US
Business Telephone3106226188
Business Fax2482784854
Authorized OfficialFRANCISCA M.S. KARTONO WINARDI, PRESIDENT
3106226188
HPT Codes
CodeLicense NoState
207N00000X PRIMARY
193400000X SINGGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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