Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Advanced Dermatology Care Medical Cosmetic and Surgery PA

Organization Dermatology Physician · NPI 1073614558

Advanced Dermatology Care Medical Cosmetic and Surgery PA is a Dermatology Physician in White Bear Lake, Minnesota. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4480 Centerville Rd
White Bear Lake, MN 55127-3674
Phone: (651) 484-2724
Fax: (651) 484-2723
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1073614558
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationAdvanced Dermatology Care Medical and Surgical Dermatology PA
Authorized official Olaf Rustad — Owner · (651) 484-2724
Other names Advanced Dermatology Care; Advanced Dermatology Care
NPI enumeratedSeptember 26, 2006
Last updated in NPPESNovember 16, 2018
Mailing address4480 Centerville Rd, White Bear Lake, MN 55127-3674

Other providers in White Bear Lake