PARK CITY DENTAL SPA NPI 1760144117

NPI Information

NPI: 1760144117
Provider Name: PARK CITY DENTAL SPA
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

CLIA Number: 46D2238515

Address:
1526 UTE BLVD STE 212
PARK CITY, UT
ZIP 84098
Phone: (435) 615-8500
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PARK CITY DENTAL SPA is a dental clinic center in Park City, UT. PARK CITY DENTAL SPA NPI is 1760144117. The provider is registered as an organization entity type.

The provider's business location address is:

1526 UTE BLVD STE 212
PARK CITY, UT
ZIP 84098-654
Phone: (435) 615-8500
Fax: (435) 214-7246

The provider's authorized official is Dawnetta Kay Abraham .
The authorized official title is Manager and has the following contact phone number (435) 615-8500.

The CLIA number assigned to this NPI record is 46D2238515 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2021 and was last updated on 10/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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