Organization
UNIVERSITY OF UTAH ADULT SERVICES
Active
Parent organization
UNIVERSITY OF UTAH ADULT SERVICES
Other names
School of Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Authorized official
EDWARD H CLARK (DEPARTMENT CHAIR)
(801) 587-6636
Entity
Organization
Contact information
Practice address
50 N MEDICAL DR CLINIC # 7, SALT LAKE CITY, UT 84132-1261
(801) 581-2016
Mailing address
PO BOX 841450, LOS ANGELES, CA 90084-1450
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
12/07/2016
Last updated
04/08/2022
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