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BRYAN E GOTTFREDSON DDS NPI 1902118557


NPI Information

NPI: 1902118557
Provider Name: BRYAN E GOTTFREDSON DDS

Other Name: MAIN STREET DENTAL OF MAGNA

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
9010 W 2700 S
MAGNA, UT
ZIP 84044
Phone: (801) 250-7311
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BRYAN E GOTTFREDSON DDS is a general practice dentist in Magna, UT. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BRYAN E GOTTFREDSON DDS NPI is 1902118557. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Main Street Dental Of Magna.

The provider's business location address is:

9010 W 2700 S
MAGNA, UT
ZIP 84044-002
Phone: (801) 250-7311
Fax: (801) 250-3801

The provider's authorized official is Bryan Elden Gottfredson .
The authorized official title is Dentist/ Owner and has the following contact phone number (801) 250-7311.

The enumeration date for this NPI number is 7/12/2010 and was last updated on 7/12/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice360010-9922UTAHYes

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

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