Provider Demographics
NPI:1184281206
Name:DENTAL ENTERPRISES
Entity type:Organization
Organization Name:DENTAL ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, CAGS
Authorized Official - Phone:801-544-3323
Mailing Address - Street 1:2025 W 200 N STE 1
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4300
Mailing Address - Country:US
Mailing Address - Phone:801-544-3323
Mailing Address - Fax:801-544-3327
Practice Address - Street 1:2025 W 200 N STE 1
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-4300
Practice Address - Country:US
Practice Address - Phone:801-544-3323
Practice Address - Fax:801-544-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty