Organization
ELITE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN BRAITHWAITE D.D.S. (OWNER)
(801) 763-7737
Entity
Organization
Contact information
Practice address
218 N WEST STATE RD, AMERICAN FORK, UT 84003-1419
(801) 763-7737
(801) 763-7757
Mailing address
218 N WEST STATE RD, AMERICAN FORK, UT 84003-1419
(801) 763-7737
(801) 763-7757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5070492-9922
UT
1223G0001X
General Practice Dentistry
5148371-9922
UT
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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