| Organization Name: | HALF DENTAL UTAH LLC |
| NPI Number: | 1932522208 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MINDY S ANDERSON (OFFICE MANAGER) |
| Mailing Address: | 2274 N 400 E Ste 202 North Ogden |
| State: | UT US |
| Postal Code: | 844147378 |
| Phone Number: | 8018525252 |
| Fax Number: | 8018557152 |
| NPI Enumeration Date: | 01/22/2014 |
| NPI Last Update Date: | 01/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 7403598-9922 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |