MEDICARE: DR. JAMES STIRLAND I D.M.D

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	122300000X	Dentist	9048624-9921	UT

General Provider Information

NPI Number	:	1912312646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES STIRLAND I D.M.D

Provider Business Mailing Address
First Line	:	699 MONT CLAIR DR
Second Line	:
City	:	NORTH SALT LAKE
State	:	UT
Zip	:	84054-3383
Country	:	US
Telephone Number	:	801-602-2732
Fax Number	:

Provider Business Practice Location Address
First Line	:	699 MONT CLAIR DR
Second Line	:
City	:	NORTH SALT LAKE
State	:	UT
Zip	:	84054-3383
Country	:	US
Telephone Number	:	801-602-2732
Fax Number	:

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

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	06/20/2014

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