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Organization
ARBUCKLE DENTAL PC
Active
Organization
ARBUCKLE DENTAL PC
Active
Other names
Arbuckle Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT KEVIN ARBUCKLE DDS (PRESIDENT)
(801) 292-0733
Entity
Organization
Contact information
Practice address
281 S MAIN ST, CENTERVILLE, UT 84014-2378
(801) 292-0733
(801) 298-5336
Mailing address
PO BOX 1088, CENTERVILLE, UT 84014-5088
(801) 292-0733
(801) 298-5336
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770526873
—
UT
05
—
528446804006
—
UT
05
—
529196351001
—
UT
05
—
529295479001
—
UT
Enumeration date
06/14/2006
Last updated
10/25/2021
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