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General NPI Number Information
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NPI Number | 1104464338
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Entity Type | Organization
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Legal Business Name | SMART DENTAL CARE
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 2180 E 4500 S
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City | SALT LAKE CITY
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State | UT
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Zip | 84117-4434
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Country | US
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Telephone | 801-272-8609
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Fax | 801-272-6167
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Provider Business Mailing Address
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Address Line | 2180 E 4500 S
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City | SALT LAKE CITY
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State | UT
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Zip | 84117-4434
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Country | US
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Telephone | 801-272-8609
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Fax | 801-272-6167
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIELSON K. ASHTON
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Credential | D.M.D
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Telephone | 801-272-8609
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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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