Provider Demographics
NPI:1558988477
Name:PLASTIC SURGERY CENTER OF DULUTH PLLC
Entity Type:Organization
Organization Name:PLASTIC SURGERY CENTER OF DULUTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:F
Authorized Official - Last Name:SALDANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:218-215-8990
Mailing Address - Street 1:324 W SUPERIOR ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1763
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:324 W SUPERIOR ST STE 100
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1763
Practice Address - Country:US
Practice Address - Phone:218-215-8990
Practice Address - Fax:218-217-4371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty