NPI 1033554217

Bella Derma Spa

Organisation Health Maintenance Organization Wake Forest, NC

Practice location

Address: 3211 Rogers Rd Suite 101, Wake Forest, NC 27587-3890
Phone: (919) 862-4459

Authorised official

Name: Demetria a Clarkson
Title: Owner, Licensed Esthetician
Phone: (919) 862-4459

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence E5619 (NC)

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Registry record

NPI: 1033554217
Entity type: Organization
NPI issued: 1 May 2013
Record last updated: 1 May 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.