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50 N Medical Dr Clinic # 7 Salt Lake City UT 84132-1261 | |
| (801) 581-2016 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 50 N Medical Dr Clinic # 7, Salt Lake City, Utah |
| Authorized Official Name and Position | Edward H Clark (DEPARTMENT CHAIR) |
| Authorized Official Contact | 8015876636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 841450 Los Angeles CA 90084-1450 Ph: (801) 213-3900 | 50 N Medical Dr Clinic # 7 Salt Lake City UT 84132-1261 Ph: (801) 581-2016 |
| NPI Number | 1083158257 |
|---|---|
| Provider Enumeration Date | 12/07/2016 |
| Last Update Date | 04/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083158257 | NPI | - | NPPES |
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