NPI 1275859589

Legacy Family Dental of Bountiful LLC

Organisation Health Maintenance Organization Bountiful, UT

Practice location

Address: 55 E 2200 S, Bountiful, UT 84010-5619
Phone: (801) 295-5115
Fax: (801) 397-5559

Authorised official

Name: Kase Peery
Title: Owner/Managing Member
Phone: (801) 870-0838

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 75313980160 (UT)

Other Health Maintenance Organization providers in Utah →

Registry record

NPI: 1275859589
Entity type: Organization
NPI issued: 12 Apr 2010
Record last updated: 12 Apr 2010

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.