Organization
FASHION PLACE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA GOODMAN (PRESIDENT)
(801) 262-7770
Entity
Organization
Contact information
Practice address
6095 S FASHION BLVD STE 290, MURRAY, UT 84107-7391
(801) 262-7770
(801) 262-2983
Mailing address
6095 S FASHION BLVD STE 290, MURRAY, UT 84107-7391
(801) 262-7770
(801) 262-2983
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
142863
UT
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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