| Slpd Cottonwood Llc | |
|
7167 South Highland Drive 200 Cottonwood Heights UT 84121 | |
| (801) 463-1900 | |
| (801) 278-0481 |
| Full Name | Slpd Cottonwood Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7167 South Highland Drive, Cottonwood Heights, Utah |
| Authorized Official Name and Position | David B Gustafson (OWNER/DENTIST) |
| Authorized Official Contact | 8014631900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Slpd Cottonwood Llc 7167 South Highland Drive 200 Cottonwood Heights UT 84121 Ph: (801) 463-1900 | Slpd Cottonwood Llc 7167 South Highland Drive 200 Cottonwood Heights UT 84121 Ph: (801) 463-1900 |
| NPI Number | 1376044313 |
|---|---|
| Provider Enumeration Date | 02/26/2018 |
| Last Update Date | 02/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376044313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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