Organization · Type 2 NPI

Restore Dermatology Clinic LLC

Dermatology Physician · Broken Arrow, OK

NPI number 1336002302 Active

Practice location

4700 W Urbana St Ste 100
Broken Arrow, OK 74012-5520

Specialties and licenses

TaxonomyCodeLicense
Dermatology Physician Primary 207N00000XNone listed

Dermatology Physician: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis an…

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About NPI 1336002302

Restore Dermatology Clinic LLC's National Provider Identifier is 1336002302, issued on Dec 6, 2025. The primary taxonomy on file is Dermatology Physician (207N00000X), and the practice location is in Broken Arrow, OK. The record was last updated on Dec 17, 2025.