| Nic - Salt Lake City, Pllc | |
|
7138 S Highland Dr Ste 109 Salt Lake City UT 84121-3776 | |
| (801) 942-7770 | |
| Not Available |
| Full Name | Nic - Salt Lake City, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7138 S Highland Dr Ste 109, Salt Lake City, Utah |
| Authorized Official Name and Position | Alex Swanson (CEO) |
| Authorized Official Contact | 8015109145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nic - Salt Lake City, Pllc 7138 S Highland Dr Ste 109 Salt Lake City UT 84121-3776 Ph: () - | Nic - Salt Lake City, Pllc 7138 S Highland Dr Ste 109 Salt Lake City UT 84121-3776 Ph: (801) 942-7770 |
| NPI Number | 1184245474 |
|---|---|
| Provider Enumeration Date | 04/28/2020 |
| Last Update Date | 08/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184245474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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