Pdc Riverton LLC

NPI #1306291422 in Riverton, Utah

Provider Information

NPI Number: 1306291422
Entity Type: Organization
Organization Name: Pdc Riverton LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 26, 2016
Last Updated: Apr 26, 2016

Practice Location

Address: 2364 W 12600 S
Address 2: STE 1A
City: Riverton
State: Utah
ZIP Code: 84065-7109
Phone: (801) 253-8866

Authorized Official

Name: TAELOR JEPPSON
Title: INSURANCE COORDINATOR
Phone: (801) 305-3460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - General Practice — General Practice	1223G0001X	Primary

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