Midvale Modern Dentistry, LLP

NPI #1407112469 in Midvale, Utah

Provider Information

NPI Number: 1407112469
Entity Type: Organization
Organization Name: Midvale Modern Dentistry, LLP
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 4, 2012
Last Updated: Dec 31, 2013

Practice Location

Address: 1144 EAST FORT UNION BOULEVARD
City: Midvale
State: Utah
ZIP Code: 84047
Phone: (801) 566-3118

Authorized Official

Name: DR. ERIC JOHN SWENSEN
Title: DDS/OWNER
Phone: (801) 566-3118

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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