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General NPI Number Information
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NPI Number | 1154619526
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Entity Type | Organization
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Legal Business Name | NOBLE DENTAL PC
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 321 E 300 N SUITE A
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City | AMERICAN FORK
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State | UT
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Zip | 84003-1790
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Country | US
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Telephone | 801-763-7655
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Fax | 801-763-7669
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Provider Business Mailing Address
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Address Line | 321 E 300 N SUITE A
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City | AMERICAN FORK
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State | UT
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Zip | 84003-1790
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Country | US
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Telephone | 801-763-7655
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Fax | 801-763-7669
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL S BURR
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Credential | DDS MSD
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Telephone | 801-763-7655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | UT
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