Organization
ELEVATE ORTHODONTICS LLC
Active
Other names
Pediatric Dental and Orthodontic Specialists at Vineyard, LC, Vineyard Pediatric Dentistry & Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER GOO (MANAGER)
(801) 382-8820
Entity
Organization
Contact information
Practice address
707 E MILL RD STE 101, VINEYARD, UT 84059-5732
(801) 544-1184
(801) 852-0440
Mailing address
707 E MILL RD STE 101, VINEYARD, UT 84059-5732
(801) 382-8820
(385) 283-0660
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
10/10/2017
Last updated
10/22/2019
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