| Wasatch Dental Group Llc | |
|
1685 W Towne Center Dr South Jordan UT 84095-8697 | |
| (801) 254-7003 | |
| (801) 281-8455 |
| Full Name | Wasatch Dental Group Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1685 W Towne Center Dr, South Jordan, Utah |
| Authorized Official Name and Position | Dane J Nelson (OWNER/PARTNER/DENTIST) |
| Authorized Official Contact | 8012547003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wasatch Dental Group Llc 1685 W Towne Center Dr South Jordan UT 84095-8697 Ph: (801) 254-7003 | Wasatch Dental Group Llc 1685 W Towne Center Dr South Jordan UT 84095-8697 Ph: (801) 254-7003 |
| NPI Number | 1700409695 |
|---|---|
| Provider Enumeration Date | 05/26/2020 |
| Last Update Date | 05/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700409695 | NPI | - | NPPES |
| 1164883104 | Other | UT | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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