| Nic-utah County, Llc | |
|
2230 N University Pkwy Ste 8b Provo UT 84604-6700 | |
| (385) 324-7064 | |
| Not Available |
| Full Name | Nic-utah County, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2230 N University Pkwy Ste 8b, Provo, 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-utah County, Llc 2230 N University Pkwy Ste 8b Provo UT 84604-6700 Ph: () - | Nic-utah County, Llc 2230 N University Pkwy Ste 8b Provo UT 84604-6700 Ph: (385) 324-7064 |
| NPI Number | 1639790918 |
|---|---|
| Provider Enumeration Date | 04/28/2020 |
| Last Update Date | 08/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639790918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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