| Van Leeuwen Dental, Llc | |
|
6936 Promenade Dr #201 Salt Lake City UT 84121-3391 | |
| (801) 943-1612 | |
| (801) 942-6008 |
| Full Name | Van Leeuwen Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6936 Promenade Dr, Salt Lake City, Utah |
| Authorized Official Name and Position | Michael Lee Van Leeuwen (DENTIST/OWNER) |
| Authorized Official Contact | 8019431612 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Van Leeuwen Dental, Llc 6936 South Promenade Dr. #201 Salt Lake City UT 84121 Ph: (801) 943-1612 | Van Leeuwen Dental, Llc 6936 Promenade Dr #201 Salt Lake City UT 84121-3391 Ph: (801) 943-1612 |
| NPI Number | 1831346527 |
|---|---|
| Provider Enumeration Date | 08/25/2008 |
| Last Update Date | 08/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831346527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 138074 (Utah) | Primary |
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