Provider Demographics
NPI:1861860173
Name:UTAH DENTAL UNITED
Entity Type:Organization
Organization Name:UTAH DENTAL UNITED
Other - Org Name:UTAH DENTAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:801-266-3236
Mailing Address - Street 1:445 E 4500 S STE 150
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3101
Mailing Address - Country:US
Mailing Address - Phone:801-266-3236
Mailing Address - Fax:801-206-3236
Practice Address - Street 1:445 E 4500 S STE 150
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-3101
Practice Address - Country:US
Practice Address - Phone:801-266-3236
Practice Address - Fax:801-206-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty