| Advanced Dental Specialty Group | |
|
1838 N 1075 W # 100 Farmington UT 84025-2980 | |
| (801) 923-1011 | |
| (801) 923-1022 |
| Full Name | Advanced Dental Specialty Group |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1838 N 1075 W # 100, Farmington, Utah |
| Authorized Official Name and Position | Shannon Bird (OFFICE MANAGER) |
| Authorized Official Contact | 8019231011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Specialty Group 1838 N 1075 W # 100 Farmington UT 84025-2980 Ph: (801) 923-1011 | Advanced Dental Specialty Group 1838 N 1075 W # 100 Farmington UT 84025-2980 Ph: (801) 923-1011 |
| NPI Number | 1730768557 |
|---|---|
| Provider Enumeration Date | 04/07/2021 |
| Last Update Date | 04/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730768557 | NPI | - | NPPES |
| 272251 | Other | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
Justin T Brown Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 670 W Shepard Lane, #105, Farmington, UT 84025 Phone: 801-447-2001 Fax: 801-447-2003 | |
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