Provider Demographics
NPI:1831064369
Name:CASCADE DENTAL CARE INC
Entity type:Organization
Organization Name:CASCADE DENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOOSLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-679-3455
Mailing Address - Street 1:3823 W 9000 S STE AB
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5603
Mailing Address - Country:US
Mailing Address - Phone:801-679-3455
Mailing Address - Fax:801-849-8291
Practice Address - Street 1:3823 W 9000 S STE AB
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5603
Practice Address - Country:US
Practice Address - Phone:801-679-3455
Practice Address - Fax:801-849-8291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental