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 1912158031

Advanced Dermatology Care Medical Cosmetic and Surgery PA is a Dermatology Physician in Forest Lake, 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.

See every abbreviation used in this directory →

Practice location Address checks out

25 Lake St N Ste 200
Forest Lake, MN 55025-2535
Phone: (651) 484-2724
Show map & directions

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 number1912158031
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Olaf Rustad — Dermatologist · (651) 484-2724
Other names Advanced Dermatology Care
NPI enumeratedOctober 7, 2008
Last updated in NPPESJanuary 11, 2010
Mailing address4480 Centerville Rd, Saint Paul, MN 55127-3674