| Cornfield Dental Center | |
|
2845 W 12600 S Riverton UT 84065-7147 | |
| (801) 254-5255 | |
| (801) 466-0819 |
| Full Name | Cornfield Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2845 W 12600 S, Riverton, Utah |
| Authorized Official Name and Position | Bong K Noh (PRESIDENT) |
| Authorized Official Contact | 8012545255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornfield Dental Center 2845 W 12600 S Riverton UT 84065-7147 Ph: (801) 254-5255 | Cornfield Dental Center 2845 W 12600 S Riverton UT 84065-7147 Ph: (801) 254-5255 |
| NPI Number | 1811975295 |
|---|---|
| Provider Enumeration Date | 01/05/2006 |
| Last Update Date | 05/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811975295 | NPI | - | NPPES |
| 575358847025 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3599589922 (Utah) | Primary |
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