Provider Demographics
NPI:1205129095
Name:UTAH VALLEY DENTAL
Entity type:Organization
Organization Name:UTAH VALLEY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:801-756-4595
Mailing Address - Street 1:686 EAST 110 SOUTH
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003
Mailing Address - Country:US
Mailing Address - Phone:801-756-4595
Mailing Address - Fax:801-756-1827
Practice Address - Street 1:686 EAST 110 SOUTH
Practice Address - Street 2:SUITE 102
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003
Practice Address - Country:US
Practice Address - Phone:801-756-4595
Practice Address - Fax:801-756-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental