Provider Demographics
NPI:1225446263
Name:APEX DENTAL DRAPER LLC
Entity Type:Organization
Organization Name:APEX DENTAL DRAPER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-748-0379
Mailing Address - Street 1:12391 S 4000 W
Mailing Address - Street 2:206
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-7012
Mailing Address - Country:US
Mailing Address - Phone:801-748-0379
Mailing Address - Fax:801-542-8188
Practice Address - Street 1:12391 S 4000 W
Practice Address - Street 2:SUITE 206
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-7012
Practice Address - Country:US
Practice Address - Phone:801-748-0379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3412371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty