Park City Dental, PC

NPI #1225469596 in Rockford, Illinois

Provider Information

NPI Number: 1225469596
Entity Type: Organization
Organization Name: Park City Dental, PC
Primary Specialty: Dentist
Enumeration Date: Dec 11, 2013
Last Updated: Dec 11, 2013

Practice Location

Address: 555 N COURT ST
Address 2: SUITE 100
City: Rockford
State: Illinois
ZIP Code: 61103-6862
Phone: (815) 708-6556

Authorized Official

Name: DR. JASON M GRINTER, DDS
Title: PRESIDENT
Phone: (815) 708-6556

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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