Provider Demographics
NPI:1801630660
Name:KUNZLER FAMILY DENTISTRY PC
Entity type:Organization
Organization Name:KUNZLER FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KUNZLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-558-0850
Mailing Address - Street 1:65 S 100 E
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84701-2600
Mailing Address - Country:US
Mailing Address - Phone:435-558-0075
Mailing Address - Fax:
Practice Address - Street 1:65 S 100 E
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-2600
Practice Address - Country:US
Practice Address - Phone:435-558-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1598810871OtherNPPES