| Falling Creek Dental Llc | |
|
112 E 12450 S Ste 101 Draper UT 84020-8057 | |
| (801) 495-3567 | |
| Not Available |
| Full Name | Falling Creek Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 112 E 12450 S Ste 101, Draper, Utah |
| Authorized Official Name and Position | Chad M Goerckeritz (OWNER) |
| Authorized Official Contact | 8014953567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Falling Creek Dental Llc 112 E 12450 S Ste 101 Draper UT 84020-8057 Ph: () - | Falling Creek Dental Llc 112 E 12450 S Ste 101 Draper UT 84020-8057 Ph: (801) 495-3567 |
| NPI Number | 1992257372 |
|---|---|
| Provider Enumeration Date | 11/01/2016 |
| Last Update Date | 11/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992257372 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7015094 (Utah) | Primary |
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