Organization
THE DERMATOLOGY HOUSE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY STANKIEWICZ (OWNER)
(415) 802-1310
Entity
Organization
Contact information
Practice address
1526 UTE BLVD, STE 104, PARK CITY, UT 84098-7522
(415) 802-1310
Mailing address
1526 UTE BLVD, STE 104, PARK CITY, UT 84098-7522
(415) 802-1310
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
04/04/2017
Last updated
02/20/2024
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