Organization
PURE DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEA HEDSTROM PA (OWNER)
(801) 475-3090
Entity
Organization
Contact information
Practice address
466 E 500 S, SALT LAKE CITY, UT 84111-3342
(801) 475-3090
Mailing address
466 E 500 S, SALT LAKE CITY, UT 84111-3342
(801) 475-3090
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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