Organization
ADVANCED DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER SHINER DDS (PRESIDENT)
(435) 828-4099
Entity
Organization
Contact information
Practice address
1272 W HIGHWAY 40, VERNAL, UT 84078-2925
(435) 781-0660
Mailing address
1272 W HIGHWAY 40, VERNAL, UT 84078-2925
(435) 781-0660
(435) 781-0661
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6712357-9923
UT
332BC3200X
Customized Equipment (DME)
6712357-9923
UT
Other
Enumeration date
11/01/2016
Last updated
11/18/2020
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