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General NPI Number Information
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NPI Number | 1922378926
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Entity Type | Organization
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Legal Business Name | HIGHLAND DENTAL CENTER, PC
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 1955 S 1300 E SUITE #1
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City | SALT LAKE CITY
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State | UT
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Zip | 84105-3658
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Country | US
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Telephone | 801-487-5755
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Fax | 801-484-5567
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Provider Business Mailing Address
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Address Line | 1955 S 1300 E SUITE #1
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City | SALT LAKE CITY
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State | UT
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Zip | 84105-3658
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Country | US
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Telephone | 801-487-5755
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Fax | 801-484-5567
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD BRUCE BARNES
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Credential | DDS
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Telephone | 801-487-5755
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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 |
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License Number State |
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