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Organization

ALPINE DERMATOLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHERYL LEE DANIELLE EBERTING M.D. (OWNER)
(801) 763-7107
Entity
Organization

Contact information

Practice address
144 S MAIN ST, SUITE 100, ALPINE, UT 84004-1666
(801) 763-7107
(801) 763-7106
Mailing address
144 S MAIN ST, SUITE 100, ALPINE, UT 84004-1666
(801) 763-7107
(801) 763-7106

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
62699311205
UT

Other

Enumeration date
02/16/2007
Last updated
09/03/2009
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