Healthcare Provider Details

I. General information

NPI: 1508297342
Provider Name (Legal Business Name): PRECISION DENTURES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MORAY CT
PARK CITY UT
84060-6947
US

IV. Provider business mailing address

1401 MORAY CT
PARK CITY UT
84060-6947
US

V. Phone/Fax

Practice location:
  • Phone: 435-513-1328
  • Fax:
Mailing address:
  • Phone: 435-513-1328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number317872-4601
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4798854-9921
License Number StateUT

VIII. Authorized Official

Name: MR. JOHN HUGGINS FLANDERS
Title or Position: CO-OWNER
Credential:
Phone: 435-513-1328