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Contact Information

INTERMOUNTAIN DENTAL SPECIALISTS, LLC
1747 HERITAGE LN
SYRACUSE, UT84075-8552
 Phone: 801-841-3300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for INTERMOUNTAIN DENTAL SPECIALISTS LLC · (Female)

NPI # 1780048868
Status Active
Credentials
Entity Individual
Enumeration date 04/05/2016
Last updated 04/05/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • UT License # 6413227-9922
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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