Organization
ARBUCKLE DENTAL PC
Active
Other names
Arbuckle Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT KEVIN ARBUCKLE DDS (PRESIDENT)
(801) 292-0733
Entity
Organization
Contact information
Practice address
281 S MAIN ST, CENTERVILLE, UT 84014-2378
(801) 292-0733
(801) 298-5336
Mailing address
PO BOX 1088, CENTERVILLE, UT 84014-5088
(801) 292-0733
(801) 298-5336
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770526873
—
UT
05
—
528446804006
—
UT
05
—
529196351001
—
UT
05
—
529295479001
—
UT
Enumeration date
06/14/2006
Last updated
10/25/2021
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