# DR. CORY M. STARK D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OUT OF THIS WORLD DENTISTRY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912035163
- **Authorized official:** MRS. CARRIE LOUISE CAMPBELL (BUSINESS MANAGER)
- **Authorized official phone:** (801) 571-6751

## Contact information

- **Practice address:** 112 E 12450 S, \#100, DRAPER, UT 84020-8056
- **Practice address phone:** (801) 571-6751
- **Practice address fax:** (801) 571-4156
- **Mailing address:** 112 E 12450 S, \#100, DRAPER, UT 84020-8056
- **Mailing address phone:** (801) 571-6751
- **Mailing address fax:** (801) 571-4156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 144937-9923 | UT | Yes |

## Other

- **Enumeration date:** 03/01/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 529865775005 | — | UT |