| NPI | 1316095722 |
|---|---|
| Doing Business As | PARK CITY DERMATOLOGY |
| Former Legal Business Name | CENTER FOR COSMETIC DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | STEVEN MARK KERN President 435-658-1013 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 3673151205) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2023-03-07 |