Provider Demographics
NPI:1255024816
Name:STARLING, LANCE DAVID (DMD)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:DAVID
Last Name:STARLING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 W DAYBREAK PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-5139
Mailing Address - Country:US
Mailing Address - Phone:801-206-4385
Mailing Address - Fax:
Practice Address - Street 1:5087 W LAKE TERRACE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009-6205
Practice Address - Country:US
Practice Address - Phone:801-360-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9363273-9923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist