Provider Demographics
NPI:1518763457
Name:DAHLE FAMILY DENTAL, PLLC
Entity type:Organization
Organization Name:DAHLE FAMILY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-900-3131
Mailing Address - Street 1:1276 E GEORGE WASHINGTON BLVD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790
Mailing Address - Country:US
Mailing Address - Phone:435-900-3131
Mailing Address - Fax:435-900-3132
Practice Address - Street 1:1276 E GEORGE WASHINGTON BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-900-3131
Practice Address - Fax:435-900-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty