PROFESSIONAL DENTAL CIRCLEVILLE LLC; NPI #1619551496

Contact Information

PROFESSIONAL DENTAL CIRCLEVILLE LLC

110 SOUTH 100 EAST
CIRCLEVILLE, UT 84723

Phone: 801-785-8000
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for PROFESSIONAL DENTAL CIRCLEVILLE LLC

NPI # 1619551496

LBN Legal business name PROFESSIONAL DENTAL CIRCLEVILLE LLC

Authorized official ROBERT HACK - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/08/2021

Last updated 05/10/2021 - About 5 years ago

Identifiers

Other

1942396643

NPI

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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