# GATEWAY AESTHETIC INSTITUTE & LASER CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124298203
- **Authorized official:** NANCY J SAMOLITIS MD (BOARD CERTIFIED DERMATOLOGIST)
- **Authorized official phone:** (801) 595-1600

## Contact information

- **Practice address:** 440 W 200 S, SUITE 250, SALT LAKE CITY, UT 84101-1345
- **Practice address phone:** (801) 595-1600
- **Practice address fax:** (801) 364-0423
- **Mailing address:** 440 W 200 S, SUITE 250, SALT LAKE CITY, UT 84101-1345
- **Mailing address phone:** (801) 595-1600
- **Mailing address fax:** (801) 364-0423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | 5216196-8905 | UT | Yes |

## Other

- **Enumeration date:** 03/05/2008
- **Last updated:** 03/05/2008