| Copper Creek Dental, Pc | |
|
3078 W 7800 S Ste 7-b West Jordan UT 84088-3707 | |
| (801) 280-1911 | |
| (801) 255-2394 |
| Full Name | Copper Creek Dental, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3078 W 7800 S, West Jordan, Utah |
| Authorized Official Name and Position | Robert J Staley (PRESIDENT/OWNER) |
| Authorized Official Contact | 8012801911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Copper Creek Dental, Pc 3078 W 7800 S Ste 7-b West Jordan UT 84088-3707 Ph: (801) 280-1911 | Copper Creek Dental, Pc 3078 W 7800 S Ste 7-b West Jordan UT 84088-3707 Ph: (801) 280-1911 |
| NPI Number | 1316962079 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316962079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 373483-9922 (Utah) | Primary |
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