Jordan Ridge Pediatric Dentistry
Clinic/Center, Dental in Murray, UT. Organization (NPI-2).
NPI number1669928909
StatusActive
Last updated in NPPESAug 28, 2016
Details
- NPI
- 1669928909
- Entity type
- Organization (NPI-2)
- Legal business name
- Jordan Ridge Pediatric Dentistry
- Organization subpart
- No
- Enumeration date
- Aug 28, 2016
- Last updated
- Aug 28, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
678 E. Vine StreetSuite #10
Murray, UT 84107
Phone 801-918-4135
Mailing address
678 E Vine StSuite #10
Murray, UT 84107-5546
Phone 801-918-4135
Authorized official
Marci Nicol
Vp Of Operations
8019184135
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