Provider Demographics
NPI:1093866105
Name:CARLTON, JANA LEIGH (DDS)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:LEIGH
Last Name:CARLTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5517 S 3775 W
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-9720
Mailing Address - Country:US
Mailing Address - Phone:801-985-0610
Mailing Address - Fax:
Practice Address - Street 1:3195 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-3749
Practice Address - Country:US
Practice Address - Phone:801-468-0342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6102878-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist