Organization
JAMSTAN P C
Active
Other names
Presley Orthodontics Family & Cosmetic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSEY R GODWIN (PRACTICE ADMINISTRATOR)
(801) 561-9999
Entity
Organization
Contact information
Practice address
204 FORT UNION BLVD STE 102, MIDVALE, UT 84047-5645
(801) 561-9999
(801) 561-9979
Mailing address
204 FORT UNION BLVD STE 102, MIDVALE, UT 84047-5645
(801) 561-9999
(801) 561-9979
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
343288-8903
UT
1223G0001X
General Practice Dentistry
343288-9922
UT
1223G0001X
General Practice Dentistry
366356-8903
UT
1223G0001X
General Practice Dentistry
Primary
3663569921
UT
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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