Healthcare Provider Details

I. General information

NPI: 1508069105
Provider Name (Legal Business Name): CHRISTOPHER JOSEPH PRICE DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2007
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3473 W SOUTH JORDAN PKWY STE 4
SOUTH JORDAN UT
84095-6016
US

IV. Provider business mailing address

3473 W SOUTH JORDAN PKWY STE 4
SOUTH JORDAN UT
84095-6016
US

V. Phone/Fax

Practice location:
  • Phone: 801-446-4428
  • Fax:
Mailing address:
  • Phone: 801-446-4428
  • Fax: 801-758-5658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number6922082-9924
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: