| Cobble Creek Dental Llc | |
|
2274 N 400 E Suite 204 North Ogden UT 84414-7378 | |
| (801) 399-0458 | |
| (801) 393-2212 |
| Full Name | Cobble Creek Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2274 N 400 E, North Ogden, Utah |
| Authorized Official Name and Position | Mark E Harris (OWNER / DENTIST) |
| Authorized Official Contact | 8013990458 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cobble Creek Dental Llc 2274 N 400 E Suite 204 North Ogden UT 84414-7378 Ph: (801) 399-0458 | Cobble Creek Dental Llc 2274 N 400 E Suite 204 North Ogden UT 84414-7378 Ph: (801) 399-0458 |
| NPI Number | 1972868453 |
|---|---|
| Provider Enumeration Date | 07/10/2012 |
| Last Update Date | 07/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972868453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6822295 (Utah) | Primary |
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