Great Smiles Dental Clinic LLC

NPI #1447623830 in Sandy, Utah

Provider Information

NPI Number: 1447623830
Entity Type: Organization
Organization Name: Great Smiles Dental Clinic LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 6, 2015
Last Updated: Nov 6, 2015

Practice Location

Address: 7410 S CREEK RD
Address 2: #303
City: Sandy
State: Utah
ZIP Code: 84093-6140
Phone: (801) 642-4080

Authorized Official

Name: MR. JOSHUA RODRIGGS
Title: GMP
Phone: (385) 355-1434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - General Practice — General Practice	1223G0001X	Primary

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