East Mountain Dental LLC

NPI #1457671299 in Provo, Utah

Provider Information

NPI Number: 1457671299
Entity Type: Organization
Organization Name: East Mountain Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 3, 2010
Last Updated: Jun 3, 2010

Practice Location

Address: 2335 S STATE ST
Address 2: SUITE 200
City: Provo
State: Utah
ZIP Code: 84606-6576
Phone: (801) 377-0037

Authorized Official

Name: RYAN G HAMILTON, DDS
Title: GENERAL DENTIST
Phone: (801) 377-0037

Specialties & Taxonomy Codes

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

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