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General NPI Number Information
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NPI Number | 1790642577
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Entity Type | Individual
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Provider Name | EMILY DALTON
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Gender |
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 2364 W 12600 S
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City | RIVERTON
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State | UT
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Zip | 84065-7109
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Country | US
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Telephone | 385-212-4824
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Fax |
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Provider Business Mailing Address
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Address Line | 12191 S PARK HAVEN LN
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City | RIVERTON
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State | UT
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Zip | 84096-7314
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 14239607-1103
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License Number State | UT
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