Organization
SIMPLY SMILES DENTAL UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISYNN DICKSON (OWNER)
(801) 613-2904
Entity
Organization
Contact information
Practice address
2592 S 5600 W STE 102, WEST VALLEY CITY, UT 84120-1274
(801) 613-2904
Mailing address
2592 S 5600 W STE 102, WEST VALLEY CITY, UT 84120-1274
(801) 613-2904
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/18/2019
Last updated
01/30/2020
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