Main Street Dental of Salt Lake City
NPI #1245607068 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1245607068
- Entity Type
- Organization
- Organization Name
- Main Street Dental of Salt Lake City
- Primary Specialty
- Point of Service
- Enumeration Date
- Aug 27, 2015
- Last Updated
- Aug 27, 2015
Practice Location
- Address
- 3195 S MAIN ST STE 201
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84115-3749
- Phone
- (801) 792-6033
Authorized Official
- Name
- JENNIFER D WILSON
- Title
- MANAGER/OWNER
- Phone
- (801) 792-6033
Specialties & Taxonomy Codes
| Specialty |
|---|
| Point of Service |
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