Provider Demographics
NPI:1972045656
Name:ISMILE AT MURRAY FAMILY DENTAL
Entity Type:Organization
Organization Name:ISMILE AT MURRAY FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TORGESON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-262-1181
Mailing Address - Street 1:164 E 5900 S
Mailing Address - Street 2:SUITE A-111
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7256
Mailing Address - Country:US
Mailing Address - Phone:801-262-1181
Mailing Address - Fax:801-262-6744
Practice Address - Street 1:164 E 5900 S
Practice Address - Street 2:SUITE A-111
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7256
Practice Address - Country:US
Practice Address - Phone:801-262-1181
Practice Address - Fax:801-262-6744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT64929351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty