Organization
CENTRAL UTAH DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEALTIEL A TINAJERO DO (PRESIDENT)
(435) 531-6269
Entity
Organization
Contact information
Practice address
861 N MAIN, RICHFIELD, UT 84701
(435) 896-4298
Mailing address
861 N MAIN, RICHFIELD, UT 84701
(435) 896-4298
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
02/21/2020
Last updated
02/21/2020
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