Michel B. Haynie

LBN: Over The Road Dental
Michel B. Haynie is an health care organization with primary practice located at 1953 W. California Ave , Salt Lake City UT 84104. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Over The Road Dental can be contacted via phone (801) 886-9341, or through Breeze, Angie via phone (801) 886-9341.

Contact Information

Primary practice address
1953 W. California Ave Salt Lake City UT 84104
Phone: (801) 886-9341
Fax: (801) 886-1786
Website:
Map and Directions
Authorized official contact:
Name: Breeze, Angie
Phone: (801) 886-9341

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 143681-9922 Utah

Profile Details

NPI number 1912014234
LBN Legal business name Over The Road Dental
DBA Doing business as Michel B. Haynie
Authorized official Breeze, Angie
Entity Organization
Organization subpart 1 No
Enumeration date Aug 23rd, 2006
Last updated Aug 22nd, 2020 - about 4 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 1912014234 NPPES
Utah MEDICAID 545764459023

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