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General NPI Number Information
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NPI Number | 1790790426
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Entity Type | Organization
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Legal Business Name | NORTHVIEW DENTAL ASSOCIATES LLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2201 N 400 E
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City | NORTH OGDEN
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State | UT
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Zip | 84414-7210
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Country | US
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Telephone | 801-782-6681
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Fax | 801-786-0539
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Provider Business Mailing Address
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Address Line | 2201 N 400 E
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City | NORTH OGDEN
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State | UT
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Zip | 84414-7210
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Country | US
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Telephone | 801-782-6681
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Fax | 801-786-0539
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL A MACKLEY
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Credential | D.D.S.
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Telephone | 801-782-6681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | UT
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