Provider Demographics
NPI:1093062978
Name:JFMC PLLC
Entity Type:Organization
Organization Name:JFMC PLLC
Other - Org Name:ZIMBI DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GETZ
Authorized Official - Last Name:CROOKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-731-5528
Mailing Address - Street 1:2779 W 4000 S
Mailing Address - Street 2:STE 101
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-9603
Mailing Address - Country:US
Mailing Address - Phone:801-731-5528
Mailing Address - Fax:801-731-8369
Practice Address - Street 1:2779 W 4000 S
Practice Address - Street 2:STE 101
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9603
Practice Address - Country:US
Practice Address - Phone:801-731-5528
Practice Address - Fax:801-731-8369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental