Provider Demographics
NPI:1760995526
Name:TD OPERATIONS LLC
Entity Type:Organization
Organization Name:TD OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:ORVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-989-7803
Mailing Address - Street 1:1380 N 225 W
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-3314
Mailing Address - Country:US
Mailing Address - Phone:801-989-7803
Mailing Address - Fax:
Practice Address - Street 1:3060 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3058
Practice Address - Country:US
Practice Address - Phone:810-972-0555
Practice Address - Fax:801-972-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8813690-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty