Organization
KAYENTA DENTAL
Active
Other names
Monticello Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TAMRA LEWIS (OFFICE MANAGER)
(435) 587-2700
Entity
Organization
Contact information
Practice address
225 S. MAIN, MONTICELLO, UT 84535
(435) 587-2700
(435) 587-3442
Mailing address
PO BOX 1125, MONTICELLO, UT 84535-1125
(435) 587-2700
(435) 587-3442
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6216233-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376698324
—
UT
Enumeration date
12/11/2014
Last updated
12/11/2014
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