Provider Demographics
NPI:1063868529
Name:WARM FAMILY DENTISTRY PC
Entity type:Organization
Organization Name:WARM FAMILY DENTISTRY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:COLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-965-9898
Mailing Address - Street 1:4546 S ATHERTON DR #201
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-6968
Mailing Address - Country:US
Mailing Address - Phone:801-965-9898
Mailing Address - Fax:801-965-6194
Practice Address - Street 1:4546 S ATHERTON DR STE 201
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84123-6968
Practice Address - Country:US
Practice Address - Phone:801-965-9898
Practice Address - Fax:801-965-6194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7554010001OtherPTAN