Organization
DR. CORY M. STARK D.D.S.
Active
Other names
OUT OF THIS WORLD DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARRIE LOUISE CAMPBELL (BUSINESS MANAGER)
(801) 571-6751
Entity
Organization
Contact information
Practice address
112 E 12450 S, #100, DRAPER, UT 84020-8056
(801) 571-6751
(801) 571-4156
Mailing address
112 E 12450 S, #100, DRAPER, UT 84020-8056
(801) 571-6751
(801) 571-4156
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
144937-9923
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529865775005
—
UT
Enumeration date
03/01/2007
Last updated
08/22/2020
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