| City Creek Dental, Pllc | |
|
175 S West Temple Ste 100 Salt Lake City UT 84101-1443 | |
| (801) 364-7943 | |
| (801) 364-3373 |
| Full Name | City Creek Dental, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 175 S West Temple Ste 100, Salt Lake City, Utah |
| Authorized Official Name and Position | Walter Landon Bye (OWNER/PARTNER) |
| Authorized Official Contact | 8013647943 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Creek Dental, Pllc 175 S West Temple Ste 100 Salt Lake City UT 84101-1443 Ph: (801) 364-7943 | City Creek Dental, Pllc 175 S West Temple Ste 100 Salt Lake City UT 84101-1443 Ph: (801) 364-7943 |
| NPI Number | 1013367036 |
|---|---|
| Provider Enumeration Date | 06/21/2016 |
| Last Update Date | 06/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013367036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5673900 (Utah) | Primary |
| 261QD0000X | Clinic/center - Dental | 7991108 (Utah) | Secondary |
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