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General NPI Number Information
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NPI Number | 1437047644
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Entity Type | Individual
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Provider Name | BROOKE VANTOORENBURG DMD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 263 COUNTRY CLUB DR STE 103
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City | STANSBURY PARK
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State | UT
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Zip | 84074-9602
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Country | US
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Telephone | 435-210-5110
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Fax |
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Provider Business Mailing Address
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Address Line | 974 E 2100 S APT 210
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-4529
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Country | US
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Telephone | 813-466-8699
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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 | 14223912
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License Number State | UT
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