Provider Demographics
NPI:1639801319
Name:THE POINT PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:THE POINT PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-282-1802
Mailing Address - Street 1:3855 W 7800 S STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5563
Mailing Address - Country:US
Mailing Address - Phone:801-282-1802
Mailing Address - Fax:801-282-6244
Practice Address - Street 1:14629 PORTER ROCKWELL BLVD
Practice Address - Street 2:STE #400
Practice Address - City:BLUFFDALE
Practice Address - State:UT
Practice Address - Zip Code:84065
Practice Address - Country:US
Practice Address - Phone:801-282-1802
Practice Address - Fax:801-282-6244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty