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1760 N Main St Suite 106 Cedar City UT 84721-7775 | |
| (435) 867-0644 | |
| (435) 867-0645 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1760 N Main St, Cedar City, Utah |
| Authorized Official Name and Position | Brian S Glazier (PRESIDENT) |
| Authorized Official Contact | 4358670644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1760 N Main St Suite 106 Cedar City UT 84721-7775 Ph: (435) 867-0644 | 1760 N Main St Suite 106 Cedar City UT 84721-7775 Ph: (435) 867-0644 |
| NPI Number | 1487070850 |
|---|---|
| Provider Enumeration Date | 03/10/2014 |
| Last Update Date | 03/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487070850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8807255-0144 (Utah) | Primary |
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