NPI 1316172596

The Tooth Doctor

Organisation Preferred Provider Organization Salt Lake City, UT

Practice location

Address: 2180 E Fort Union Blvd., Salt Lake City, UT 84121
Phone: (801) 944-4141
Fax: (801) 944-6377

Authorised official

Name: Ray E Dillman
Title: Owner
Phone: (801) 944-4141

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 1395529922 (UT)

Other Preferred Provider Organization providers in Utah →

Registry record

NPI: 1316172596
Entity type: Organization
NPI issued: 18 May 2009
Record last updated: 18 May 2009

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.