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Organization
RALLISON DENTAL LLC
Active
Organization
RALLISON DENTAL LLC
Active
Other names
Clearfield Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER MONTY RALLISON DMD (GENERAL DENTIST)
(801) 663-6451
Entity
Organization
Contact information
Practice address
183 N MAIN ST, CLEARFIELD, UT 84015-2395
(801) 825-1822
Mailing address
183 N MAIN ST, CLEARFIELD, UT 84015-2395
(801) 825-1822
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891144739
—
UT
Enumeration date
05/25/2021
Last updated
07/02/2021
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