Organization
COPPER CREEK DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J STALEY D.M.D (PRESIDENT/OWNER)
(801) 280-1911
Entity
Organization
Contact information
Practice address
3078 W 7800 S, STE 7-B, WEST JORDAN, UT 84088-3707
(801) 280-1911
(801) 255-2394
Mailing address
3078 W 7800 S, STE 7-B, WEST JORDAN, UT 84088-3707
(801) 280-1911
(801) 255-2394
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
373483-9922
UT
Other
Enumeration date
07/13/2006
Last updated
08/22/2020
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