Healthcare Provider Details

I. General information

NPI: 1316859002
Provider Name (Legal Business Name): DEVANTIER ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 S 2600 W STE 102
HURRICANE UT
84737-3753
US

IV. Provider business mailing address

85 S 2600 W STE 102
HURRICANE UT
84737-3753
US

V. Phone/Fax

Practice location:
  • Phone: 435-216-8214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOFFER L DEVANTIER
Title or Position: ORTHODONTIST/OWNER
Credential: DMD, MS
Phone: 435-216-8214