| Stansbury Park Pediatric Dentistry | |
|
263 Country Clb Ste 102 Stansbury Park UT 84074-9602 | |
| (435) 580-8800 | |
| Not Available |
| Full Name | Stansbury Park Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 263 Country Clb Ste 102, Stansbury Park, Utah |
| Authorized Official Name and Position | Alisha Shigley (OFFICE MANAGER) |
| Authorized Official Contact | 4355808800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stansbury Park Pediatric Dentistry 11996 S Anthem Park Blvd Ste 102 Herriman UT 84096-5643 Ph: (435) 580-8800 | Stansbury Park Pediatric Dentistry 263 Country Clb Ste 102 Stansbury Park UT 84074-9602 Ph: (435) 580-8800 |
| NPI Number | 1487295218 |
|---|---|
| Provider Enumeration Date | 10/02/2019 |
| Last Update Date | 10/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487295218 | NPI | - | NPPES |
| 1346761152 | Other | UT | NPI |
| 1811237076 | Other | UT | NPI |
| 1275821415 | Other | UT | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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