Organization
STONEHAVEN DENTAL - WEST VALLEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF REIBEL (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
4577 S 4000 W STE B, WEST VALLEY CITY, UT 84120-6222
(502) 254-8500
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/15/2018
Last updated
09/05/2023
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