BASIN FAMILY DENTAL LLC
NPI 1295317667
Clinic/Center - Dental in Roosevelt, UT
Active since April 26, 2021
About Basin Family Dental Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BASIN FAMILY DENTAL LLC (NPI 1295317667) is a healthcare organization registered as a dental in Roosevelt, Utah and active in the NPI registry since April 2021. The organization lists Tiffany Bray, Manager, as its authorized official.
NPPES Registry Identity
NPI1295317667
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameBASIN FAMILY DENTAL LLC
Location Address209 W 200 N # 71Roosevelt, UT 84066-2835
Mailing Address209 W 200 N # 71Roosevelt, UT 84066-2835 · (435) 722-2111
Phone(435) 722-2111
Organization SubpartNo
Authorized OfficialTiffany BrayManager · (435) 637-2100
Enumeration DateApril 26, 2021
NPPES CertifiedApril 26, 2021
✔ NPI 1295317667 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
209 W 200 N # 71, Roosevelt, UT 84066
Other Identifiers 1
Medicaid600290118011UT
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295317667, enumerated as an "organization" on April 26, 2021.
The provider is located at 209 W 200 N # 71 ROOSEVELT, UT 84066 and the phone number is (435) 722-2111.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
