MEDICARE: STEVEN HUNTSMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9702	AZ

General Provider Information

NPI Number	:	1093933269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN HUNTSMAN DDS

Provider Business Mailing Address
First Line	:	2630 W 3500 S STE C
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-3113
Country	:	US
Telephone Number	:	801-542-0126
Fax Number	:	801-987-3251

Provider Business Practice Location Address
First Line	:	2630 W 3500 S STE C
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-3113
Country	:	US
Telephone Number	:	801-542-0126
Fax Number	:	801-987-3251

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/21/2022

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