Organization
SUMMIT DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A BLAMIRES D.D.S (OWNER)
(801) 547-8800
Entity
Organization
Contact information
Practice address
3225 W GORDON AVE, SUITE 4, LAYTON, UT 84041-8769
(801) 547-8800
Mailing address
3225 W GORDON AVE, SUITE 4, LAYTON, UT 84041-8769
(801) 547-8800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
309191-9922
UT
1223G0001X
General Practice Dentistry
361602-9923
UT
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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