Ridge Park Dental
Dentist, General Practice in Layton, UT. Organization (NPI-2).
NPI number1982107306
StatusActive
Last updated in NPPESJun 16, 2018
Details
- NPI
- 1982107306
- Entity type
- Organization (NPI-2)
- Legal business name
- Ridge Park Dental
- Organization subpart
- No
- Enumeration date
- Mar 12, 2018
- Last updated
- Jun 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 275232 | UT | Yes |
Other names
- Dr. Grant A. Brough, DDS, PC (Former Legal Business Name)
- Grant A Brough, DDS, PC (Former Legal Business Name)
Practice location
2307 N Hill Field Rd Ste 101Layton, UT 84041-6890
Phone 801-773-5285 · Fax 801-773-2850
Mailing address
2307 N Hill Field Rd Ste 101Layton, UT 84041-6890
Phone 801-773-5285 · Fax 801-773-2850
Authorized official
Grant Atwood Brough
Owner/Operator
8017735285
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