Midvale Pdc Pllc | |
204 E Fort Union Blvd Ste 102 Midvale UT 84047-5645 | |
(801) 561-9999 | |
Not Available |
Full Name | Midvale Pdc Pllc |
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Speciality | Clinic/center - Dental |
Location | 204 E Fort Union Blvd Ste 102, Midvale, Utah |
Authorized Official Name and Position | Kayla Shade (REVENUE CYCLE MANAGER) |
Authorized Official Contact | 8013053460 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Midvale Pdc Pllc Po Box 970324 Orem UT 84097-0324 Ph: () - | Midvale Pdc Pllc 204 E Fort Union Blvd Ste 102 Midvale UT 84047-5645 Ph: (801) 561-9999 |
NPI Number | 1659087237 |
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Provider Enumeration Date | 01/26/2023 |
Last Update Date | 01/26/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659087237 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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