Fairbanks Family Dental

NPI #1356779995 in West Jordan, Utah

Provider Information

NPI Number: 1356779995
Entity Type: Organization
Organization Name: Fairbanks Family Dental
Primary Specialty: Dentist
Enumeration Date: Oct 16, 2013
Last Updated: Oct 16, 2013

Practice Location

Address: 2414 W 7800 S
Address 2: SUITE B
City: West Jordan
State: Utah
ZIP Code: 84088-4292
Phone: (385) 275-7400

Authorized Official

Name: DR. JAMES LEO FAIRBANKS, DMD
Title: DENTIST/OWNER
Phone: (385) 275-7400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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