Organization
UTAH SMILE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY ROBERTS DDS (OWNER/DENTIST)
(801) 590-8694
Entity
Organization
Contact information
Practice address
6321 S REDWOOD RD STE 206, TAYLORSVILLE, UT 84123-6972
(801) 590-8694
(801) 290-2761
Mailing address
6321 S REDWOOD RD STE 206, TAYLORSVILLE, UT 84123-6972
(801) 590-8694
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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