Organization
CORNFIELD DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONG K NOH DDS (PRESIDENT)
(801) 254-5255
Entity
Organization
Contact information
Practice address
2845 W 12600 S, RIVERTON, UT 84065-7147
(801) 254-5255
(801) 466-0819
Mailing address
2845 W 12600 S, RIVERTON, UT 84065-7147
(801) 254-5255
(801) 466-0819
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3599589922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
575358847025
—
UT
Enumeration date
01/05/2006
Last updated
05/08/2008
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