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 1144486978

Advanced Dermatology Care Medical Cosmetic and Surgery PA is a Dermatology Physician in Stillwater, Minnesota. Licensed in Minnesota. Registered with an NPI since 2008.

Licensed in
MN
In the registry since
2008
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

14130 60th St N
Stillwater, MN 55082-6354
Phone: (651) 484-2724
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 1376 (MN)

Record details

NPI number1144486978
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Olaf Rustad — Dermatologist President · (651) 484-2724
Other names Advanced Dermatology Care
NPI enumeratedJuly 31, 2008
Last updated in NPPESMarch 11, 2024
Certification dateMarch 11, 2024
Mailing address4480 Centerville Rd, White Bearlake, MN 55127

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