Organization
BURDETT DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL S. BURDETT D.D.S. (PRESIDENT)
(801) 475-0680
Entity
Organization
Contact information
Practice address
5640 WASATCH DR, SUITE D, OGDEN, UT 84403-4902
(801) 475-0680
(801) 475-0685
Mailing address
5640 WASATCH DR, SUITE D, OGDEN, UT 84403-4902
(801) 475-0680
(801) 475-0685
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
131585
UT
1223G0001X
General Practice Dentistry
Primary
293245
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529657754001
—
UT
Enumeration date
01/06/2007
Last updated
08/22/2020
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