| Pony Exress Orthodontics, Llc | |
|
5396 W Daybreak Pkwy South Jordan UT 84009-5900 | |
| (801) 614-7669 | |
| Not Available |
| Full Name | Pony Exress Orthodontics, Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 5396 W Daybreak Pkwy, South Jordan, Utah |
| Authorized Official Name and Position | Amanda Garner (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8016147669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pony Exress Orthodontics, Llc 5396 W Daybreak Pkwy South Jordan UT 84009-5900 Ph: (801) 614-7669 | Pony Exress Orthodontics, Llc 5396 W Daybreak Pkwy South Jordan UT 84009-5900 Ph: (801) 614-7669 |
| NPI Number | 1174012876 |
|---|---|
| Provider Enumeration Date | 05/08/2018 |
| Last Update Date | 05/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174012876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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