Organization
STANSBURY PEDIATRIC DENTISTRY AND ORTHODONTICS
Active
Other names
Dentistry 4 The kids
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRISHA RICHARD TAYLOR DMD (DENTIST)
(435) 840-1025
Entity
Organization
Contact information
Practice address
220 MILLPOND, SUITE #106, STANSBURY PARK, UT 84074-9745
(435) 840-1025
(435) 882-2680
Mailing address
PO BOX 1249, TOOELE, UT 84074-1249
(435) 840-1025
(435) 882-2680
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4753208-9923
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296664784000
—
UT
Enumeration date
11/17/2007
Last updated
11/17/2007
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