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General NPI Number Information
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NPI Number | 1801085063
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Entity Type | Individual
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Provider Name | CRAIG A YOUNG DMD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 1231 W. 9000 S. SUITE D
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City | WEST JORDAN
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State | UT
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Zip | 84088
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Country | US
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Telephone | 801-999-4431
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Fax | 801-878-7035
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Provider Business Mailing Address
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Address Line | 1055 RUTH ST. STE 2
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City | PRESCOTT
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State | AZ
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Zip | 86301
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Country | US
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Telephone | 928-775-8448
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Fax | 928-443-3278
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7399
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5925457-9922
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License Number State | UT
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