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475 N 300 W Ste 1 Kaysville UT 84037-3112 | |
| (801) 546-2413 | |
| (801) 546-1900 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 475 N 300 W Ste 1, Kaysville, Utah |
| Authorized Official Name and Position | Christopher Robert Godfrey (OWNER) |
| Authorized Official Contact | 8016636144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2087 N 725 W Centerville UT 84014-3465 Ph: (801) 663-6144 | 475 N 300 W Ste 1 Kaysville UT 84037-3112 Ph: (801) 546-2413 |
| NPI Number | 1497320121 |
|---|---|
| Provider Enumeration Date | 05/25/2021 |
| Last Update Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497320121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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