| Alta Canyon Dental | |
|
1434 E 9400 S Ste 200 Sandy UT 84093-2900 | |
| (801) 572-4404 | |
| Not Available |
| Full Name | Alta Canyon Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1434 E 9400 S Ste 200, Sandy, Utah |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta Canyon Dental 1434 E 9400 S Ste 200 Sandy UT 84093-2900 Ph: (801) 572-4404 | Alta Canyon Dental 1434 E 9400 S Ste 200 Sandy UT 84093-2900 Ph: (801) 572-4404 |
| NPI Number | 1720660061 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 04/26/2021 |
| Certification Date | 04/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720660061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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