| Out Of This World Dentistry Sj Pc | |
|
10426 S. 4000 W. South Jordan UT 84009 | |
| (801) 260-0400 | |
| (801) 619-5399 |
| Full Name | Out Of This World Dentistry Sj Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10426 S. 4000 W., South Jordan, Utah |
| Authorized Official Name and Position | Cory Stark (OWNER) |
| Authorized Official Contact | 8012600400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Out Of This World Dentistry Sj Pc 10426 S. 4000 W. South Jordan UT 84009 Ph: (801) 260-0400 | Out Of This World Dentistry Sj Pc 10426 S. 4000 W. South Jordan UT 84009 Ph: (801) 260-0400 |
| NPI Number | 1811396260 |
|---|---|
| Provider Enumeration Date | 08/21/2014 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811396260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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