OrganizationActive
Premier Dermatology & Skin Renewal Center
NPI 1912912361 · Clinical & Laboratory Dermatological Immunology Physician · Bentonville, AR
Provider details
- NPI number
- 1912912361
- Entity type
- Organization
- Primary specialty
- Clinical & Laboratory Dermatological Immunology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeff Clifton, Coo(479) 273-3376
- License
- E3363 (AR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
909 Se 28th St
Ste 5
Bentonville, AR 72712-3880
Phone: (479) 273-3376
Fax: (479) 273-3468
Approximate (ZIP-level) locationGet directions
Mailing address
909 Se 28th St
Bentonville, AR 72712-3880
Registry dates
- Enumerated
- 2006-07-31
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.