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General NPI Number Information
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NPI Number | 1619797008
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Entity Type | Organization
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Legal Business Name | SBB GROUP
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 3000 W 1700 S
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City | SYRACUSE
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State | UT
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Zip | 84075
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Country | US
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Telephone | 801-888-4912
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N WELDEN WAY
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City | LAYTON
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State | UT
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Zip | 84041-8864
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Country | US
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Telephone | 801-888-4912
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TAYLOR JAY ALLRED
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Credential | DMD
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Telephone | 801-888-4912
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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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