| Magna Dental Clinic | |
|
3564 S 7200 W Ste B Magna UT 84044-3507 | |
| (801) 250-1717 | |
| (801) 250-6098 |
| Full Name | Magna Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3564 S 7200 W Ste B, Magna, Utah |
| Authorized Official Name and Position | Lynn S Johnson (OWNER) |
| Authorized Official Contact | 8012501717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magna Dental Clinic 3564 S 7200 W Ste B Magna UT 84044-3507 Ph: (801) 250-1717 | Magna Dental Clinic 3564 S 7200 W Ste B Magna UT 84044-3507 Ph: (801) 250-1717 |
| NPI Number | 1790077915 |
|---|---|
| Provider Enumeration Date | 05/05/2011 |
| Last Update Date | 05/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790077915 | NPI | - | NPPES |
| 1881802494 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 137173 (Utah) | Primary |
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