Organization
DENALI DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN JENSEN (OWNER/PRESIDENT)
(801) 544-4204
Entity
Organization
Contact information
Practice address
47 CRESTWOOD RD, STE. #3, KAYSVILLE, UT 84037-1445
(801) 544-4204
(801) 546-6140
Mailing address
47 CRESTWOOD RD, STE. #3, KAYSVILLE, UT 84037-1445
(801) 544-4204
(801) 546-6140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
322402-9922
UT
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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