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General NPI Number Information
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NPI Number | 1851255301
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Entity Type | Organization
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Legal Business Name | SANTAQUIN DENTISTRY LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 451 E MAIN ST
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City | SANTAQUIN
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State | UT
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Zip | 84655-7267
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Country | US
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Telephone | 801-658-0221
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Fax | 801-658-0232
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Provider Business Mailing Address
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Address Line | 451 E MAIN ST
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City | SANTAQUIN
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State | UT
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Zip | 84655-7267
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Country | US
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Telephone | 801-658-0221
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Fax | 801-658-0232
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Authorized Official
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Title or Position | OWNER
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Name | KYLE R MARSHALL
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Credential |
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Telephone | 801-658-0221
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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 |
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