Salt Lake Dental Care
Dentist, General Practice in Salt Lake City, UT. Organization (NPI-2).
NPI number1437682002
StatusActive
Last updated in NPPESApr 10, 2017
Details
- NPI
- 1437682002
- Entity type
- Organization (NPI-2)
- Legal business name
- Salt Lake Dental Care
- Organization subpart
- No
- Enumeration date
- Apr 10, 2017
- Last updated
- Apr 10, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 5936346 | UT | Yes |
Practice location
279 E 5900 S Ste 202Salt Lake City, UT 84107-5425
Phone 801-938-8855 · Fax 801-880-9832
Mailing address
279 E 5900 S Ste 202Salt Lake City, UT 84107-5425
Phone 801-938-8855 · Fax 801-880-9832
Authorized official
Clint Blackwood
Dentist
8019388855
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