Healthcare Provider Details

I. General information

NPI: 1659145407
Provider Name (Legal Business Name): MADISON A. DAY, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S RICHMOND ST UNIT A
SALT LAKE CITY UT
84106-3005
US

IV. Provider business mailing address

3001 S RICHMOND ST UNIT A
SALT LAKE CITY UT
84106-3005
US

V. Phone/Fax

Practice location:
  • Phone: 801-467-6555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MADISON DAY
Title or Position: OWNER
Credential: DDS
Phone: 801-712-3043