NPI 1295212884

Wisdom Teeth Centers LLC

Organisation Dentist Stansbury Park, UT

Practice location

Address: 263 Country Clb STE 103, Stansbury Park, UT 84074-9602
Phone: (801) 566-8833
Mailing address: PO Box 708130, Sandy, UT 84070-8130

Authorised official

Name: Joseph S Maio
Title: Owner/Dentist
Phone: (801) 566-8833

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 341237 (UT)

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Registry record

NPI: 1295212884
Entity type: Organization
NPI issued: 26 Jul 2018
Record last updated: 26 Jul 2018

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.