Organization
LAKEVIEW DENTAL SYRACUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY GUTIERREZ (OFFICE MANAGER)
(801) 825-2273
Entity
Organization
Contact information
Practice address
1662 S 2000 W, STE A1, SYRACUSE, UT 84075-7137
(801) 825-2273
Mailing address
1662 S 2000 W, STE A1, SYRACUSE, UT 84075-7137
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5370773
UT
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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