NPI 1780912147 · live from the CMS NPI Registry
39th & 13th Street Dental
Dentist in Holladay, UT. National Provider Identifier 1780912147, active.
NPI record
| NPI | 1780912147 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 1345 E 3900 S, Suite 206, Holladay, UT 84124 |
| Practice phone | 801-278-1333 |
| Mailing address | 1345 East 3900 South, Suite 206, Holladay, UT 84124 |
| Enumerated | November 24, 2009 |
| Last updated | July 21, 2022 |
| Authorized official | Steven Pinegar, Dentist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | — (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.