PROVIDENCE DERMATOLOGY LLC

Dermatology

Active Organization
NPI: 1568029957

Practice Address

169 N GATEWAY DR STE 100
Providence, UT 84332

Phone: (541) 999-4475

Specialties

Specialty Code Primary License
Dermatology - MOHS-Micrographic Surgery 207ND0101X No -
Dermatology 207N00000X Yes -

Frequently Asked Questions

NPI 1568029957 is the National Provider Identifier for PROVIDENCE DERMATOLOGY LLC, a Dermatology provider located in Providence, UT. This NPI was enumerated on May 22, 2019.

Quick Facts

NPI
1568029957
Type
Organization
Enumerated
May 22, 2019
Last Updated
Jun 16, 2025

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