| Liberty Mountain Dental Llc | |
|
6351 W 13400 S Ste 100 Herriman UT 84096-5601 | |
| (385) 237-5252 | |
| Not Available |
| Full Name | Liberty Mountain Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6351 W 13400 S Ste 100, Herriman, Utah |
| Authorized Official Name and Position | Trevor Ross Lindgren (PRINCIPAL OWNER (CEO)) |
| Authorized Official Contact | 8014405520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Mountain Dental Llc 1860 N 40 E Orem UT 84057-2235 Ph: (801) 440-5520 | Liberty Mountain Dental Llc 6351 W 13400 S Ste 100 Herriman UT 84096-5601 Ph: (385) 237-5252 |
| NPI Number | 1679182612 |
|---|---|
| Provider Enumeration Date | 07/27/2020 |
| Last Update Date | 07/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679182612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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