Healthcare Provider Details

I. General information

NPI: 1952495210
Provider Name (Legal Business Name): JASON G BARTON DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 EAST 100 SOUTH SUITE E
SALT LAKE CITY UT
84102
US

IV. Provider business mailing address

928 EAST 100 SOUTH SUITE E
SALT LAKE CITY UT
84102
US

V. Phone/Fax

Practice location:
  • Phone: 801-355-5657
  • Fax:
Mailing address:
  • Phone: 801-355-5657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5310263
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5310263
License Number StateUT

VIII. Authorized Official

Name: DR. JASON GOLDEN BARTON
Title or Position: PRESIDENT
Credential: DDS
Phone: 801-355-5657