| Liddell Family Dentistry | |
|
702 E South Temple Ste 209 Salt Lake City UT 84102-1795 | |
| (801) 359-8282 | |
| Not Available |
| Full Name | Liddell Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 702 E South Temple Ste 209, Salt Lake City, Utah |
| Authorized Official Name and Position | Jonathan C Liddell (PARTNER) |
| Authorized Official Contact | 8017330406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liddell Family Dentistry 702 E South Temple Ste 209 Salt Lake City UT 84102-1795 Ph: (801) 359-8282 | Liddell Family Dentistry 702 E South Temple Ste 209 Salt Lake City UT 84102-1795 Ph: (801) 359-8282 |
| NPI Number | 1346458932 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 02/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346458932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 512081-9922 (Utah) | Primary |
| 1223G0001X | Dentist - General Practice | 22-13695-9922 (Utah) | Secondary |
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