Provider Demographics
NPI:1891668430
Name:COMPLETESMILES COTTONWOOD - ACCELERATE LLC
Entity type:Organization
Organization Name:COMPLETESMILES COTTONWOOD - ACCELERATE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-943-9090
Mailing Address - Street 1:7240 S HIGHLAND DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6523
Mailing Address - Country:US
Mailing Address - Phone:801-943-9090
Mailing Address - Fax:385-799-6909
Practice Address - Street 1:7240 S HIGHLAND DR STE 102
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6523
Practice Address - Country:US
Practice Address - Phone:801-943-9090
Practice Address - Fax:385-799-6909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental