MEDICARE: JOYFUL SMILES FAMILY DENTISTRY, P.C.

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	5105713	UT

General Provider Information

NPI Number	:	1437164001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFUL SMILES FAMILY DENTISTRY, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 477
Second Line	:
City	:	HUNTSVILLE
State	:	UT
Zip	:	84317-0477
Country	:	US
Telephone Number	:	801-745-1222
Fax Number	:	801-745-1233

Provider Business Practice Location Address
First Line	:	237 S 7400 E
Second Line	:	BUILDING A
City	:	HUNTSVILLE
State	:	UT
Zip	:	84317-9722
Country	:	US
Telephone Number	:	801-745-1222
Fax Number	:	801-745-1233

Authorized Official
Title or Position	:	PRESIDENT/DIRECTOR
Name	:	DR. JOY DACQUEL CLEM
Credential	:	D.D.S.
Telephone Number	:	801-745-1222

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	08/22/2020

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