Provider Demographics
NPI:1770236002
Name:TASKER AND ROWAN DENTAL CORPORATION OF SANDY
Entity Type:Organization
Organization Name:TASKER AND ROWAN DENTAL CORPORATION OF SANDY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-479-3432
Mailing Address - Street 1:9853 S 700 E
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-3900
Mailing Address - Country:US
Mailing Address - Phone:916-479-3432
Mailing Address - Fax:
Practice Address - Street 1:9853 S 700 E
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-3900
Practice Address - Country:US
Practice Address - Phone:916-479-3432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental