Out Of This World Dentistry

LBN: Dr. Cory M. Stark D.D.S.
Out Of This World Dentistry is an health care organization with primary practice located at 112 E 12450 S #100, Draper UT 84020-8056. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Dr. Cory M. Stark D.D.S. can be contacted via phone (801) 571-6751, or through Campbell, Carrie Louise via phone (801) 571-6751.

Contact Information

Primary practice address
112 E 12450 S #100 Draper UT 84020-8056
Phone: (801) 571-6751
Fax: (801) 571-4156
Website:
Map and Directions
Authorized official contact:
Name: Campbell, Carrie Louise
Phone: (801) 571-6751

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 144937-9923 Utah

Profile Details

NPI number 1912035163
LBN Legal business name Dr. Cory M. Stark D.D.S.
DBA Doing business as Out Of This World Dentistry
Authorized official Campbell, Carrie Louise
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912035163 NPPES
Utah MEDICAID 529865775005

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