Grandpa's Dental Inc.

NPI #1144422429 in Provo, Utah

Provider Information

NPI Number
1144422429
Entity Type
Organization
Organization Name
Grandpa's Dental Inc.
Primary Specialty
Dentist
Enumeration Date
May 31, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
777 NORTH 500 WEST
Address 2
201B
City
Provo
State
Utah
ZIP Code
84601-1570
Phone
(801) 374-5100

Authorized Official

Name
MR. ABRAHAM RODRIGUES
Title
PRESIDENT
Phone
(801) 374-5100

Specialties & Taxonomy Codes

Specialty
Dentist

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