| Stansbury Pediatric Dentistry | |
|
220 Millpond Suite #107 Stansbury Park UT 84074-9745 | |
| (435) 843-5437 | |
| Not Available |
| Full Name | Stansbury Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 220 Millpond, Stansbury Park, Utah |
| Authorized Official Name and Position | Marci Nicol (VP OF OPERATIONS) |
| Authorized Official Contact | 8019184135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stansbury Pediatric Dentistry 220 Millpond Suite #107 Stansbury Park UT 84074-9745 Ph: (435) 843-5437 | Stansbury Pediatric Dentistry 220 Millpond Suite #107 Stansbury Park UT 84074-9745 Ph: (435) 843-5437 |
| NPI Number | 1154742054 |
|---|---|
| Provider Enumeration Date | 12/18/2013 |
| Last Update Date | 12/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154742054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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