Organization
INTERMOUNTAIN SKIN CANCER & ESTHETICS CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID EDGAR ALLEN M.D. (MEDICAL DOCTOR)
(801) 627-0515
Entity
Organization
Contact information
Practice address
3860 JACKSON AVE STE 2, OGDEN, UT 84403-1997
(801) 627-0515
(801) 627-0517
Mailing address
3860 JACKSON AVE, SUITE 2, OGDEN, UT 84403-1956
(801) 627-0515
(801) 627-0517
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
159426-1205
UT
174400000X
Specialist
323171-1206
UT
174400000X
Specialist
Primary
5316026-1205
UT
Other
Enumeration date
07/09/2006
Last updated
01/07/2016
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