Provider Demographics
NPI:1437547411
Name:THANKSGIVING POINT FAMILY DENTAL
Entity Type:Organization
Organization Name:THANKSGIVING POINT FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALGARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:801-766-5300
Mailing Address - Street 1:3098 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4713
Mailing Address - Country:US
Mailing Address - Phone:801-766-5300
Mailing Address - Fax:801-766-5445
Practice Address - Street 1:3098 EXECUTIVE PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4713
Practice Address - Country:US
Practice Address - Phone:801-766-5300
Practice Address - Fax:801-766-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental