RALLISON DENTAL LLC NPI 1205401973

NPI Information

NPI: 1205401973
Provider Name: RALLISON DENTAL LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
183 N MAIN ST
CLEARFIELD, UT
ZIP 84015
Phone: (801) 825-1822
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RALLISON DENTAL LLC is a dental clinic center in Clearfield, UT. RALLISON DENTAL LLC NPI is 1205401973. The provider is registered as an organization entity type.

The provider's business location address is:

183 N MAIN ST
CLEARFIELD, UT
ZIP 84015-395
Phone: (801) 825-1822

The provider's authorized official is Tyler Monty Rallison .
The authorized official title is General Dentist and has the following contact phone number (801) 663-6451.

The enumeration date for this NPI number is 5/25/2021 and was last updated on 7/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1891144739	MEDICAID	UTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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