| Mountain Ridge Dental | |
|
1256 S State St Suite 103 Orem UT 84097-8237 | |
| (801) 224-7182 | |
| (801) 235-0835 |
| Full Name | Mountain Ridge Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1256 S State St, Orem, Utah |
| Authorized Official Name and Position | John Green (OWNER, DOCTOR) |
| Authorized Official Contact | 8012247182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Ridge Dental 1256 S State St Suite 103 Orem UT 84097-8237 Ph: (801) 224-7182 | Mountain Ridge Dental 1256 S State St Suite 103 Orem UT 84097-8237 Ph: (801) 224-7182 |
| NPI Number | 1417240888 |
|---|---|
| Provider Enumeration Date | 05/18/2011 |
| Last Update Date | 05/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417240888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7692415-9922 (Utah) | Primary |
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