Provider Demographics
NPI:1255657722
Name:BESTCARE DENTAL LLC
Entity type:Organization
Organization Name:BESTCARE DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-225-0471
Mailing Address - Street 1:390 W 920 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-3042
Mailing Address - Country:US
Mailing Address - Phone:801-225-0471
Mailing Address - Fax:801-225-4461
Practice Address - Street 1:390 W 920 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3042
Practice Address - Country:US
Practice Address - Phone:801-225-0471
Practice Address - Fax:801-225-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT56798149922261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental