| Pony Express Dental Daybreak, Llc | |
|
5396 W Daybreak Parkway South Jordan UT 84009 | |
| (801) 876-7669 | |
| Not Available |
| Full Name | Pony Express Dental Daybreak, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5396 W Daybreak Parkway, South Jordan, Utah |
| Authorized Official Name and Position | Michael Tornow (OWNER) |
| Authorized Official Contact | 8018767669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pony Express Dental Daybreak, Llc 1308 E Eagle Mountain Blvd Eagle Mountain UT 84005-5412 Ph: (801) 876-7669 | Pony Express Dental Daybreak, Llc 5396 W Daybreak Parkway South Jordan UT 84009 Ph: (801) 876-7669 |
| NPI Number | 1104347061 |
|---|---|
| Provider Enumeration Date | 06/30/2017 |
| Last Update Date | 06/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104347061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5015649-8903 (Utah) | Primary |
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