# OUT OF THIS WORLD DENTISTRY PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Out of This World Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558760959
- **Authorized official:** DANNIELLE STARK (OFFICE MANAGER)
- **Authorized official phone:** (801) 898-7502

## Contact information

- **Practice address:** 112 E 12450 S STE 100, DRAPER, UT 84020-8057
- **Practice address phone:** (801) 571-6751
- **Practice address fax:** (801) 571-4156
- **Mailing address:** 112 E 12450 S STE 100, DRAPER, UT 84020-8057
- **Mailing address phone:** (801) 571-6751
- **Mailing address fax:** (801) 571-4156

## Taxonomy

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

## Other

- **Enumeration date:** 08/21/2014
- **Last updated:** 08/21/2014