| White Pine Endodontics Pc | |
|
169 N Gateway Dr Ste 200 Providence UT 84332-9516 | |
| (435) 760-4346 | |
| Not Available |
| Full Name | White Pine Endodontics Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 169 N Gateway Dr Ste 200, Providence, Utah |
| Authorized Official Name and Position | Jordan Hansen (PRESIDENT) |
| Authorized Official Contact | 4357604346 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Pine Endodontics Pc 169 N Gateway Dr Ste 200 Providence UT 84332-9516 Ph: () - | White Pine Endodontics Pc 169 N Gateway Dr Ste 200 Providence UT 84332-9516 Ph: (435) 760-4346 |
| NPI Number | 1457874059 |
|---|---|
| Provider Enumeration Date | 07/25/2017 |
| Last Update Date | 07/25/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457874059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 8362186-9922 (Utah) | Primary |
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