Organization
STONEHAVEN DENTAL - EAGLE MOUNTAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF REIBEL (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
3566 E PONY EXPRESS PKWY STE 1, EAGLE MOUNTAIN, UT 84005-5680
(502) 254-8500
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
09/05/2023
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