Greater Endodontics Llc | |
5334 South Woodrow Street Suite 201 Salt Lake City UT 84107 | |
(801) 268-3636 | |
(801) 942-7652 |
Full Name | Greater Endodontics Llc |
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Speciality | Dentist - Endodontics |
Location | 5334 South Woodrow Street, Salt Lake City, Utah |
Authorized Official Name and Position | Randall Madsen (MANAGING MEMBER) |
Authorized Official Contact | 8012683636 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Greater Endodontics Llc P.o. Box 71277 Salt Lake City UT 84171 Ph: (801) 268-3636 | Greater Endodontics Llc 5334 South Woodrow Street Suite 201 Salt Lake City UT 84107 Ph: (801) 268-3636 |
NPI Number | 1043725799 |
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Provider Enumeration Date | 12/04/2017 |
Last Update Date | 12/04/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043725799 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223E0200X | Dentist - Endodontics | 5639652 (Utah) | Primary |
1223E0200X | Dentist - Endodontics | 77525365 (Utah) | Secondary |
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