850 E 300 S Slc Dental LLC
Clinic/Center, Dental in Salt Lake City, UT. Organization (NPI-2).
NPI number1629645239
StatusActive
Last updated in NPPESJun 10, 2021
Details
- NPI
- 1629645239
- Entity type
- Organization (NPI-2)
- Legal business name
- 850 E 300 S Slc Dental LLC
- Organization subpart
- No
- Enumeration date
- Jun 10, 2021
- Certification date
- Jun 10, 2021
- Last updated
- Jun 10, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- 3rd South Dental (Doing Business As)
Practice location
850 E 300 S Ste 3Salt Lake City, UT 84102-2397
Phone 801-355-0380 · Fax 801-355-0384
Mailing address
850 E 300 S Ste 3Salt Lake City, UT 84102-2397
Phone 801-355-0380 · Fax 801-355-0384
Authorized official
Melissa Lowther
Office Manager
8013550380
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