Provider Demographics
NPI:1447315692
Name:ALVORD, DAVID LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LYNN
Last Name:ALVORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 W 10600 S
Mailing Address - Street 2:SUITE A2
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8697
Mailing Address - Country:US
Mailing Address - Phone:801-254-7003
Mailing Address - Fax:801-878-8699
Practice Address - Street 1:1685 W 10600 S
Practice Address - Street 2:SUITE A2
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8697
Practice Address - Country:US
Practice Address - Phone:801-254-7003
Practice Address - Fax:801-878-8699
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT566037-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice