Provider Demographics
NPI:1407689854
Name:BARRY SORENSON DENTAL, PLLC
Entity type:Organization
Organization Name:BARRY SORENSON DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SORENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-529-1000
Mailing Address - Street 1:20 E 200 N
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:UT
Mailing Address - Zip Code:84654-1220
Mailing Address - Country:US
Mailing Address - Phone:435-529-1000
Mailing Address - Fax:435-529-7044
Practice Address - Street 1:20 E 200 N
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:UT
Practice Address - Zip Code:84654-1220
Practice Address - Country:US
Practice Address - Phone:435-529-1000
Practice Address - Fax:435-529-7044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty