| Park City Pediatric Dentistry | |
|
1901 Prospector Ave Park City UT 84060-7207 | |
| (435) 649-5001 | |
| Not Available |
| Full Name | Park City Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1901 Prospector Ave, Park City, Utah |
| Authorized Official Name and Position | Marci Nicol (VP OF OPERATIONS) |
| Authorized Official Contact | 8019184135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park City Pediatric Dentistry 1901 Prospector Ave Park City UT 84060-7207 Ph: (435) 649-5001 | Park City Pediatric Dentistry 1901 Prospector Ave Park City UT 84060-7207 Ph: (435) 649-5001 |
| NPI Number | 1508287475 |
|---|---|
| Provider Enumeration Date | 12/19/2013 |
| Last Update Date | 12/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508287475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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