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General NPI Number Information
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NPI Number | 1255024816
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Entity Type | Individual
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Provider Name | LANCE DAVID STARLING DMD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 5087 W LAKE TERRACE AVE
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-6205
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Country | US
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Telephone | 801-360-4770
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Fax |
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Provider Business Mailing Address
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Address Line | 4775 W DAYBREAK PKWY STE 103
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-5139
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Country | US
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Telephone | 801-206-4385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 9363273-9923
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License Number State | UT
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