Provider Demographics
NPI:1699122275
Name:SPECIALTY MARKETING, LLC
Entity type:Organization
Organization Name:SPECIALTY MARKETING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-232-5851
Mailing Address - Street 1:732 E 300 N
Mailing Address - Street 2:
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-3131
Mailing Address - Country:US
Mailing Address - Phone:801-707-8740
Mailing Address - Fax:
Practice Address - Street 1:BLDG D 12 FREEPORT INDUSTRIAL PARKWAY
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84016
Practice Address - Country:US
Practice Address - Phone:801-707-8740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECIALTY MARKETING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty