| Jordan Valley Dental | |
|
7613 S Jordan Landing Blvd Ste 110 West Jordan UT 84084-1973 | |
| (801) 282-2323 | |
| (801) 282-3440 |
| Full Name | Jordan Valley Dental |
|---|---|
| Speciality | Dentist |
| Location | 7613 S Jordan Landing Blvd Ste 110, West Jordan, Utah |
| Authorized Official Name and Position | Brigham G Colton (OWNER/DENTIST) |
| Authorized Official Contact | 8012822323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Valley Dental 7613 S Jordan Landing Blvd West Jordan UT 84084-1972 Ph: (801) 282-2323 | Jordan Valley Dental 7613 S Jordan Landing Blvd Ste 110 West Jordan UT 84084-1973 Ph: (801) 282-2323 |
| NPI Number | 1366891798 |
|---|---|
| Provider Enumeration Date | 06/07/2016 |
| Last Update Date | 06/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366891798 | NPI | - | NPPES |
| 528618929002 UT | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5926034 (Utah) | Primary |
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