Provider Demographics
NPI:1528577624
Name:DORIUS ARCH DENTAL
Entity Type:Organization
Organization Name:DORIUS ARCH DENTAL
Other - Org Name:DORIUS DENTAL DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:FLOYD
Authorized Official - Last Name:DORIUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-671-2666
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-0792
Mailing Address - Country:US
Mailing Address - Phone:435-657-1700
Mailing Address - Fax:
Practice Address - Street 1:380 E 1500 S STE 205
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3942
Practice Address - Country:US
Practice Address - Phone:435-657-1700
Practice Address - Fax:435-657-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT47449411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty