Provider Demographics
NPI:1912090804
Name:LINDSAY, STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 S 1300 E
Mailing Address - Street 2:APT #20
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3642
Mailing Address - Country:US
Mailing Address - Phone:801-599-2480
Mailing Address - Fax:
Practice Address - Street 1:3672 W SOUTH JORDAN PKWY
Practice Address - Street 2:SUITE D104
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-7171
Practice Address - Country:US
Practice Address - Phone:801-599-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6244643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist