Progressive Dental Group | |
928 East 100 South Suite E Salt Lake City UT 84102 | |
(801) 355-5657 | |
Not Available |
Full Name | Progressive Dental Group |
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Speciality | Dentist |
Location | 928 East 100 South, Salt Lake City, Utah |
Authorized Official Name and Position | Jason Golden Barton (PRESIDENT) |
Authorized Official Contact | 8013555657 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Progressive Dental Group 928 East 100 South Suite E Salt Lake City UT 84102 Ph: (801) 355-5657 | Progressive Dental Group 928 East 100 South Suite E Salt Lake City UT 84102 Ph: (801) 355-5657 |
NPI Number | 1952495210 |
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Provider Enumeration Date | 10/03/2006 |
Last Update Date | 07/18/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952495210 | NPI | - | NPPES |
529-29-5011-001 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 5310263 (Utah) | Primary |
1223G0001X | Dentist - General Practice | 5310263 (Utah) | Secondary |
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