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General NPI Number Information
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NPI Number | 1578094702
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Entity Type | Organization
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Legal Business Name | NKA HOLDINGS PLLC
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 3451 S 5600 W
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-1301
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Country | US
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Telephone | 801-969-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 3552 S 1300 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-2936
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Country | US
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Telephone | 801-915-6049
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. NIELSON KIRK ASHTON
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Credential | DMD
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Telephone | 801-915-6049
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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 | 9296076
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License Number State | UT
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