Organization
MANTI FAMILY DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD R. ASTE D.D.S. (PRESIDENT)
(435) 835-4881
Entity
Organization
Contact information
Practice address
93 S MAIN ST, MANTI, UT 84642-1350
(435) 835-4881
Mailing address
93 S MAIN ST, MANTI, UT 84642-1350
(435) 835-4881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
144952-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529083004011
—
UT
Enumeration date
05/14/2007
Last updated
08/22/2020
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