| Family Dental Care | |
|
2500 S State St # 404 South Salt Lake UT 84115-3164 | |
| (385) 646-4747 | |
| (385) 646-4348 |
| Full Name | Family Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2500 S State St # 404, South Salt Lake, Utah |
| Authorized Official Name and Position | Tanner M. Clark (DIRECTOR/MANAGER/DENTIST) |
| Authorized Official Contact | 2083178555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Care 10597 S Beach Comber Way South Jordan UT 84009-6132 Ph: (208) 317-8555 | Family Dental Care 2500 S State St # 404 South Salt Lake UT 84115-3164 Ph: (385) 646-4747 |
| NPI Number | 1578196861 |
|---|---|
| Provider Enumeration Date | 02/15/2020 |
| Last Update Date | 02/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578196861 | NPI | - | NPPES |
| 1679841811 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |