Organization
ADVANCED VEIN AND VASCULAR CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS MUNFORD (CEO)
(801) 425-4200
Entity
Organization
Contact information
Practice address
6321 S REDWOOD RD STE 102, TAYLORSVILLE, UT 84123-6799
(385) 388-8003
(385) 344-4006
Mailing address
6321 S REDWOOD RD STE 102, TAYLORSVILLE, UT 84123-6799
(385) 388-8003
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
09/18/2021
Last updated
02/04/2022
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