Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Premier Dermatology & Skin Renewal Center

Organization Dermatology Physician · NPI 1912912361

Premier Dermatology & Skin Renewal Center is a Dermatology Physician in Bentonville, Arkansas. Licensed in Arkansas. Registered with an NPI since 2006.

Licensed in
AR
In the registry since
2006
Specialties on file
4

Practice location Address checks out

909 SE 28th St Ste 5
Bentonville, AR 72712-3880
Phone: (479) 273-3376
Fax: (479) 273-3468
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical & Laboratory Dermatological Immunology Physician (primary) Taxonomy 207NI0002X (AR)
Dermatology Physician Taxonomy 207N00000X · Licence E3363 (AR)
Pediatric Dermatology Physician Taxonomy 207NP0225X · Licence E3363 (AR)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence E3363 (AR)

Record details

NPI number1912912361
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeff Clifton — Coo · (479) 273-3376
NPI enumeratedJuly 31, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address909 Se 28th St, Ste 5, Bentonville, AR 72712-3880

Other providers in Bentonville