Copper Creek Dental, PC
NPI #1316962079 in West Jordan, Utah
Provider Information
- NPI Number
- 1316962079
- Entity Type
- Organization
- Organization Name
- Copper Creek Dental, PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jul 13, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 3078 W 7800 S
- Address 2
- STE 7-B
- City
- West Jordan
- State
- Utah
- ZIP Code
- 84088-3707
- Phone
- (801) 280-1911
Authorized Official
- Name
- DR. ROBERT J STALEY, D.M.D
- Title
- PRESIDENT/OWNER
- Phone
- (801) 280-1911
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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