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General NPI Number Information
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NPI Number | 1043173214
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Entity Type | Organization
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Legal Business Name | ALL CROWNS DENTAL, LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 223 S 700 E STE 4
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-2175
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Country | US
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Telephone | 801-895-3165
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Fax | 801-895-3165
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Provider Business Mailing Address
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Address Line | 710 E 200 S STE 1C SUITE 4
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-2265
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Country | US
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Telephone | 801-895-3165
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | ROBERT PALMER
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Credential |
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Telephone | 801-895-3165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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