Bountiful Dentistry

NPI 1053743922 - Dentist - 1223G0001X

NPI Details
NPI 1053743922
Enumeration Date 08/02/2013
Last Updated 08/02/2013
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MARK MARK
Position PART OWNER
Phone (801) 292-0443
Fax
Practice Location
625 E 500 S
SUITE 201
BOUNTIFUL UT, 84010-3882, US
Phone (801) 292-0443
Fax
Business Location
625 E 500 S
SUITE 201
BOUNTIFUL UT, 84010-3882, US
Phone (801) 292-0443
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Utah
License Number 2013-45880
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According to our database, Bountiful Dentistry NPI is 1053743922, taxonomy code is 1223G0001X and license number is 2013-45880, license state is located at Utah. Bountiful Dentistry physically located at 625 E 500 S, Bountiful UT, 84010-3882. NPI Number 1033115704 has the healthcare provider type.

1053743922 NPI number is provided on an as is basis without warranty of any kind. 1053743922 is maintained by the National Plan & Provider Enumeration System. The contents of Bountiful Dentistry are for informational purposes only.