| Out Of This World Dentistry | |
|
112 E 12450 S #100 Draper UT 84020-8056 | |
| (801) 571-6751 | |
| (801) 571-4156 |
| Full Name | Out Of This World Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 112 E 12450 S, Draper, Utah |
| Authorized Official Name and Position | Carrie Louise Campbell (BUSINESS MANAGER) |
| Authorized Official Contact | 8015716751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Out Of This World Dentistry 112 E 12450 S #100 Draper UT 84020-8056 Ph: (801) 571-6751 | Out Of This World Dentistry 112 E 12450 S #100 Draper UT 84020-8056 Ph: (801) 571-6751 |
| NPI Number | 1912035163 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912035163 | NPI | - | NPPES |
| 529865775005 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 144937-9923 (Utah) | Primary |
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