NPI 1013358449

Stansbury Dental and Implant Center Pdc PLLC

Organisation Dentist Stansbury Park, UT

Practice location

Address: 263 Country Club Dr. Suite 103, Stansbury Park, UT 84074-9600
Phone: (432) 882-2850
Mailing address: PO Box 970596, Orem, UT 84097-0309

Authorised official

Name: Jacob Warner
Title: Credentialing Manager
Phone: (801) 691-1701

Registered specialties (4)

Dentist Primary

Dental Providers Taxonomy 122300000X

Other Dentist providers in Utah →

Dentist

Dental Providers Taxonomy 122300000X Licence 341237 (UT)

Periodontics

Dental Providers Taxonomy 1223P0300X

Orthodontics and Dentofacial Orthopedics Dentistry

Dental Providers Taxonomy 1223X0400X

Registry record

NPI: 1013358449
Entity type: Organization
NPI issued: 15 Jul 2013
Record last updated: 19 Dec 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.