| Basin Family Dental Llc | |
|
209 W 200 N # 71 Roosevelt UT 84066-2835 | |
| (435) 722-2111 | |
| Not Available |
| Full Name | Basin Family Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 209 W 200 N # 71, Roosevelt, Utah |
| Authorized Official Name and Position | Tiffany Bray (MANAGER) |
| Authorized Official Contact | 4356372100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Basin Family Dental Llc 209 W 200 N # 71 Roosevelt UT 84066-2835 Ph: (435) 722-2111 | Basin Family Dental Llc 209 W 200 N # 71 Roosevelt UT 84066-2835 Ph: (435) 722-2111 |
| NPI Number | 1295317667 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 04/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295317667 | NPI | - | NPPES |
| 600290118011 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Robinson Dental & Implants Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 675 Rodeo Dr, Roosevelt, UT 84066 Phone: 435-725-3368 Fax: 435-725-3370 | |
Pinnacle Dental Partners Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 W 200 N, Roosevelt, UT 84066 Phone: 435-722-2111 |