Individual
REBECCA MOSTATAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4531 W PARTRIDGEHILL LANE, SUITE F-110, RIVERTON, UT 84096
(610) 506-6100
Mailing address
382 S BLUFF ST STE 250, ST GEORGE, UT 84770-3672
(610) 506-6100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11522571-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326502840
—
UT
Enumeration date
10/12/2006
Last updated
07/22/2020
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