Healthcare Provider Details

I. General information

NPI: 1134095151
Provider Name (Legal Business Name): CARE ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5136 S COTTONWOOD LN
HOLLADAY UT
84117-7102
US

IV. Provider business mailing address

5136 S COTTONWOOD LN
HOLLADAY UT
84117-7102
US

V. Phone/Fax

Practice location:
  • Phone: 801-631-1312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number
License Number State

VIII. Authorized Official

Name: DR. MITCHELL D DUCKWORTH
Title or Position: OWNER
Credential: DDS
Phone: 801-718-6395