DERMATOLOGY CENTER OF SALT LAKE INC. NPI 1689635799

NPI Information

DERMATOLOGY CENTER OF SALT LAKE INC. is a specialist in Midvale, UT. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY CENTER OF SALT LAKE INC. NPI is 1689635799. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7396 UNION PARK AVE
#201
MIDVALE, UT
ZIP 84047-700
Phone: (801) 567-1400
Fax: (801) 567-1777

The provider's authorized official is Joseph D Jensen .
The authorized official title is Md/owner and has the following contact phone number (801) 567-1400.

The CLIA number assigned to this NPI record is 46D0972534 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/29/2006 and was last updated on 4/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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