South Ogen Pdc Pllc | |
5300 Adams Ave Pkwy Ogden UT 84405-6902 | |
(801) 476-1234 | |
Not Available |
Full Name | South Ogen Pdc Pllc |
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Speciality | Dentist - General Practice |
Location | 5300 Adams Ave Pkwy, Ogden, Utah |
Authorized Official Name and Position | Jacob Warner (CREDENTIALING MANAGER) |
Authorized Official Contact | 8016911701 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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South Ogen Pdc Pllc Po Box 970328 Orem UT 84097-0309 Ph: (801) 476-1234 | South Ogen Pdc Pllc 5300 Adams Ave Pkwy Ogden UT 84405-6902 Ph: (801) 476-1234 |
NPI Number | 1649894486 |
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Provider Enumeration Date | 06/06/2020 |
Last Update Date | 06/06/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649894486 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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