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Organization

OUT OF THIS WORLD DENTISTRY SJ PC

Active
Parent organization
OUT OF THIS WORLD DENTISTRY PC
Other names
Out of This World SJ
Organization subpart
Yes

Provider details

NPI number
Legal business name
OUT OF THIS WORLD DENTISTRY PC
Authorized official
CORY STARK DDS (OWNER)
(801) 260-0400
Entity
Organization

Contact information

Practice address
10426 S. 4000 W., SOUTH JORDAN, UT 84009
(801) 260-0400
(801) 619-5399
Mailing address
10426 S. 4000 W., SOUTH JORDAN, UT 84009
(801) 260-0400
(801) 619-5399

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
08/21/2014
Last updated
07/21/2022
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