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General NPI Number Information
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NPI Number | 1184347841
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Entity Type | Organization
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Legal Business Name | FAIRFIELD PDC PLLC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 1086 N FAIRFIELD RD
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City | LAYTON
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State | UT
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Zip | 84041-8353
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Country | US
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Telephone | 801-547-8880
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Fax | 801-547-8911
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Provider Business Mailing Address
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Address Line | PO BOX 971414
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City | OREM
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State | UT
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Zip | 84097-1414
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Country | US
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Telephone | 801-547-8880
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Fax | 801-547-8911
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGEMENT
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Name | ALICIA LARSEN
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Credential |
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Telephone | 801-305-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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