# OUT OF THIS WORLD DENTISTRY WJ PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OUT OF THIS WORLD DENTISTRY PC
- **Other names:** Out of This World Dentistry WJ
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336548841
- **Legal business name:** OUT OF THIS WORLD DENTISTRY PC
- **Authorized official:** DANNIELLE STARK (OFFICE MANAGER)
- **Authorized official phone:** (801) 898-7502

## Contact information

- **Practice address:** 6787 S REDWOOD RD, SUITE \#100, WEST JORDAN, UT 84084-2404
- **Practice address phone:** (801) 542-7009
- **Practice address fax:** (801) 748-0920
- **Mailing address:** 6787 S REDWOOD RD, SUITE \#100, WEST JORDAN, UT 84084-2404
- **Mailing address phone:** (801) 542-7009
- **Mailing address fax:** (801) 748-0920

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 144937 | UT | Yes |

## Other

- **Enumeration date:** 08/20/2014
- **Last updated:** 08/20/2014