Provider Demographics
NPI:1417575879
Name:UTAH FAMILY DENTAL COTTONWOOD HEIGHTS
Entity Type:Organization
Organization Name:UTAH FAMILY DENTAL COTTONWOOD HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STOBBE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-849-1812
Mailing Address - Street 1:394 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-2746
Mailing Address - Country:US
Mailing Address - Phone:435-849-1812
Mailing Address - Fax:
Practice Address - Street 1:7069 S HIGHLAND DR STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3731
Practice Address - Country:US
Practice Address - Phone:801-943-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UTAH FAMILY DENTAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty