| Professional Dental Slc Llc | |
|
1632 W 700 N Ste A-1 Salt Lake City UT 84116-1903 | |
| (801) 785-8000 | |
| (801) 785-4030 |
| Full Name | Professional Dental Slc Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1632 W 700 N Ste A-1, Salt Lake City, Utah |
| Authorized Official Name and Position | Robert D Hack (OWNER) |
| Authorized Official Contact | 8016360110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Slc Llc Po Box 1806 Orem UT 84059-1806 Ph: (801) 785-8000 | Professional Dental Slc Llc 1632 W 700 N Ste A-1 Salt Lake City UT 84116-1903 Ph: (801) 785-8000 |
| NPI Number | 1235977240 |
|---|---|
| Provider Enumeration Date | 07/16/2024 |
| Last Update Date | 07/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235977240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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