Bluffdale Dental
Exclusive Provider Organization in Bluffdale, UT. Organization (NPI-2).
NPI number1982142824
StatusActive
Last updated in NPPESFeb 10, 2017
Details
- NPI
- 1982142824
- Entity type
- Organization (NPI-2)
- Legal business name
- Bluffdale Dental
- Organization subpart
- No
- Enumeration date
- Feb 10, 2017
- Last updated
- Feb 10, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | 5483941 | UT | Yes |
Practice location
14100 S Redwood RdBluffdale, UT 84065-5204
Phone 801-254-2626 · Fax 801-849-1444
Mailing address
14100 S Redwood RdBluffdale, UT 84065-5204
Phone 801-254-2626 · Fax 801-849-1444
Authorized official
David Babcock
Dentist
8012542626
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