Provider Demographics
NPI:1750736377
Name:MOUNTAIN VIEW PEDIATRIC DENTISTRY OF FARMINGTON
Entity type:Organization
Organization Name:MOUNTAIN VIEW PEDIATRIC DENTISTRY OF FARMINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:QUAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-447-5437
Mailing Address - Street 1:991 SHEPARD LANE, STE 100
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2702
Mailing Address - Country:US
Mailing Address - Phone:801-447-5437
Mailing Address - Fax:801-447-4685
Practice Address - Street 1:991 SHEPARD LANE, STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2702
Practice Address - Country:US
Practice Address - Phone:801-447-5437
Practice Address - Fax:801-447-4685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty