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678 East Vine Street Ste. #10 Murray UT 84107 | |
| (801) 918-4135 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 678 East Vine Street, Murray, Utah |
| Authorized Official Name and Position | Marci Nicol (COO) |
| Authorized Official Contact | 8019184135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
678 E Vine St Ste 10 Murray UT 84107-5500 Ph: (801) 918-4135 | 678 East Vine Street Ste. #10 Murray UT 84107 Ph: (801) 918-4135 |
| NPI Number | 1316469703 |
|---|---|
| Provider Enumeration Date | 07/07/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316469703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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