Provider Demographics
NPI:1659776367
Name:NORTH VIEW DENTAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NORTH VIEW DENTAL ASSOCIATES, LLC
Other - Org Name:MOUNTAIN VIEW DENTAL ASSOCIATES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-786-0500
Mailing Address - Street 1:2717 N HIGHWAY 89
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84404-1205
Mailing Address - Country:US
Mailing Address - Phone:801-737-2410
Mailing Address - Fax:801-737-5100
Practice Address - Street 1:2717 N HIGHWAY 89
Practice Address - Street 2:SUITE 100
Practice Address - City:PLEASANT VIEW
Practice Address - State:UT
Practice Address - Zip Code:84404-1205
Practice Address - Country:US
Practice Address - Phone:801-737-2410
Practice Address - Fax:801-737-5100
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH VIEW DENTAL ASSOICATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT144024-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty