| Granger Orthodontics | |
|
3725 W 4100 S Salt Lake City UT 84120-5530 | |
| (801) 966-6681 | |
| (801) 966-6600 |
| Full Name | Granger Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3725 W 4100 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Robert R Taylor (OWNER) |
| Authorized Official Contact | 8019666681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granger Orthodontics 3725 W 4100 S Salt Lake City UT 84120-5530 Ph: (801) 966-6681 | Granger Orthodontics 3725 W 4100 S Salt Lake City UT 84120-5530 Ph: (801) 966-6681 |
| NPI Number | 1245519750 |
|---|---|
| Provider Enumeration Date | 08/15/2011 |
| Last Update Date | 08/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245519750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 7026989 (Utah) | Primary |
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