Provider Demographics
NPI:1194167247
Name:ALLURERX,LLC
Entity type:Organization
Organization Name:ALLURERX,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:D
Authorized Official - Last Name:SLOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-981-1214
Mailing Address - Street 1:7125 E LINCOLN DR
Mailing Address - Street 2:SUITE B210
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4429
Mailing Address - Country:US
Mailing Address - Phone:480-981-1214
Mailing Address - Fax:480-981-1625
Practice Address - Street 1:1818 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6814
Practice Address - Country:US
Practice Address - Phone:480-981-1214
Practice Address - Fax:480-981-1625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3368207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty