Provider Demographics
NPI:1508297342
Name:PRECISION DENTURES, LLC
Entity Type:Organization
Organization Name:PRECISION DENTURES, LLC
Other - Org Name:PRECISION MOBILE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HUGGINS
Authorized Official - Last Name:FLANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-513-1328
Mailing Address - Street 1:1401 MORAY CT
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-6947
Mailing Address - Country:US
Mailing Address - Phone:435-513-1328
Mailing Address - Fax:
Practice Address - Street 1:1401 MORAY CT
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-6947
Practice Address - Country:US
Practice Address - Phone:435-513-1328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4798854-9921122300000X
UT317872-4601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1508297342Medicaid