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NPI Code Detail

MEDICARE: CORY J FABRIZIO DMD

MEDICARE:   CORY J FABRIZIO  DMD
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
1122300000XDentist10158CO

General Provider Information

NPI Number : 1811215395
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORY J FABRIZIO DMD
Provider Business Mailing Address
First Line : 2741 E CANTON LN
Second Line :
City : SANDY
State : UT
Zip : 84092-7126
Country : US
Telephone Number : 801-566-0971
Fax Number :
Provider Business Practice Location Address
First Line : 9233 S REDWOOD RD
Second Line :
City : WEST JORDAN
State : UT
Zip : 84088-5808
Country : US
Telephone Number : 801-566-0971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2010
Last Update Date : 09/28/2023

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Directions to “ CORY J FABRIZIO DMD” Practice Location

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