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General NPI Number Information
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NPI Number | 1912728098
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Entity Type | Organization
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Legal Business Name | UTAH DENTAL HEALTH PROFESSIONALS, P.C.
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 119 W CROSSROADS BLVD STE E
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-5563
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Country | US
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Telephone | 385-374-1104
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Fax | 385-374-1113
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Provider Business Mailing Address
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Address Line | 119 W CROSSROADS BLVD STE E
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-5563
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Country | US
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Telephone | 385-374-1104
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Fax | 385-374-1113
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | CEMYIRA MCDOUGAL
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Credential |
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Telephone | 217-764-8609
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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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