| Senior Smiles Utah Llc | |
|
10597 S Beach Comber Way South Jordan UT 84009-6132 | |
| (801) 415-6847 | |
| Not Available |
| Full Name | Senior Smiles Utah Llc |
|---|---|
| Speciality | Dentist |
| Location | 10597 S Beach Comber Way, South Jordan, Utah |
| Authorized Official Name and Position | Tanner M. Clark (OWNER/DENTIST) |
| Authorized Official Contact | 8014156847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Smiles Utah Llc 10597 S Beach Comber Way South Jordan UT 84009-6132 Ph: (208) 317-8555 | Senior Smiles Utah Llc 10597 S Beach Comber Way South Jordan UT 84009-6132 Ph: (801) 415-6847 |
| NPI Number | 1386277689 |
|---|---|
| Provider Enumeration Date | 02/15/2020 |
| Last Update Date | 02/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386277689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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