Provider Demographics
NPI:1033372297
Name:TRAPNELL ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:TRAPNELL ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRAPNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDSMS
Authorized Official - Phone:801-465-2541
Mailing Address - Street 1:1107 S HIGHWAY 198
Mailing Address - Street 2:P.O. BOX 406
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-3213
Mailing Address - Country:US
Mailing Address - Phone:801-465-2541
Mailing Address - Fax:801-465-1169
Practice Address - Street 1:89 W 900 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1161
Practice Address - Country:US
Practice Address - Phone:801-798-8343
Practice Address - Fax:801-798-7506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT367768-99221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty