| NPI | 1013358449 |
|---|---|
| Doing Business As | STANSBURY DENTAL AND IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | JACOB WARNER Credentialing Manager 801-691-1701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 341237) |
| 1223P0300X Dentist, Periodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2019-12-19 |