| NPI | 1194561670 |
|---|---|
| Doing Business As | ST. GEORGE DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | TRENT KENWORTHY Owner 435-313-7237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-09-10 |