| Platinum Dental Care - Provo | |
|
2520 N University Ave Ste 101 Provo UT 84604-6081 | |
| (801) 426-6255 | |
| Not Available |
| Full Name | Platinum Dental Care - Provo |
|---|---|
| Speciality | Dentist |
| Location | 2520 N University Ave Ste 101, Provo, Utah |
| Authorized Official Name and Position | Jessie L Kitchen (INSURANCE COORDINATOR) |
| Authorized Official Contact | 8013053460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Platinum Dental Care - Provo 2520 N University Ave Ste 101 Provo UT 84604-6081 Ph: (801) 426-6255 | Platinum Dental Care - Provo 2520 N University Ave Ste 101 Provo UT 84604-6081 Ph: (801) 426-6255 |
| NPI Number | 1730586355 |
|---|---|
| Provider Enumeration Date | 11/25/2014 |
| Last Update Date | 11/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730586355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3104344 (Utah) | Primary |
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