Provider Demographics
NPI:1093933269
Name:HUNTSMAN, STEVEN (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:HUNTSMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 W 3500 S STE C
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3113
Mailing Address - Country:US
Mailing Address - Phone:801-542-0126
Mailing Address - Fax:801-987-3251
Practice Address - Street 1:2630 W 3500 S STE C
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3113
Practice Address - Country:US
Practice Address - Phone:801-542-0126
Practice Address - Fax:801-987-3251
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ97021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice