Organization
FAIRBANKS FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES LEO FAIRBANKS DMD (DENTIST/OWNER)
(385) 275-7400
Entity
Organization
Contact information
Practice address
2414 W 7800 S, SUITE B, WEST JORDAN, UT 84088-4292
(385) 275-7400
(385) 351-6621
Mailing address
2414 W 7800 S, SUITE B, WEST JORDAN, UT 84088-4292
(385) 275-7400
(385) 351-6621
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8385285-9922
UT
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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