| Organization Name: | HOLLADAY CENTER DENTAL |
| NPI Number: | 1265685176 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NICHOLAS B LAFEBER (OWNER DOCTOR) |
| Mailing Address: | 2160 E 4500 S Ste 3 Holladay |
| State: | UT US |
| Postal Code: | 841174499 |
| Phone Number: | 8012779213 |
| Fax Number: | 8012770956 |
| NPI Enumeration Date: | 10/23/2008 |
| NPI Last Update Date: | 10/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 320562 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |