Msg Dental LLC
Dentist, General Practice in Provo, UT. Organization (NPI-2).
NPI number1982155909
StatusActive
Last updated in NPPESOct 14, 2016
Details
- NPI
- 1982155909
- Entity type
- Organization (NPI-2)
- Legal business name
- Msg Dental LLC
- Organization subpart
- No
- Enumeration date
- Oct 14, 2016
- Last updated
- Oct 14, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 8372408-9922 | UT | Yes |
Other names
- Cougar Dental (Doing Business As)
Practice location
835 N 700 EProvo, UT 84606-6993
Phone 801-373-7700
Mailing address
835 N 700 EProvo, UT 84606-6993
Phone 801-373-7700
Authorized official
Todd C Groesbeck
Dentist
8013737700
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