Redwood Periodontics, Llc | |
6287 S Redwood Rd Ste 102 Salt Lake City UT 84123-6653 | |
(801) 293-8833 | |
(801) 293-8844 |
Full Name | Redwood Periodontics, Llc |
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Speciality | Dentist - Periodontics |
Location | 6287 S Redwood Rd Ste 102, Salt Lake City, Utah |
Authorized Official Name and Position | Jeremy Dwight Manwaring (OWNER) |
Authorized Official Contact | 8012938833 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Redwood Periodontics, Llc 6287 S Redwood Rd Ste 102 Salt Lake City UT 84123-6653 Ph: (801) 293-8833 | Redwood Periodontics, Llc 6287 S Redwood Rd Ste 102 Salt Lake City UT 84123-6653 Ph: (801) 293-8833 |
NPI Number | 1558487827 |
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Provider Enumeration Date | 03/21/2007 |
Last Update Date | 07/23/2008 |
Identifier | Type | State | Issuer |
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1558487827 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0300X | Dentist - Periodontics | 56827969922 (Utah) | Primary |
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