West Jordan Pdc LLC
NPI #1588043780 in West Jordan, Utah
Provider Information
- NPI Number
- 1588043780
- Entity Type
- Organization
- Organization Name
- West Jordan Pdc LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 21, 2015
- Last Updated
- Jul 6, 2021
Practice Location
- Address
- 7555 CENTER VIEW CT
- Address 2
- STE 104
- City
- West Jordan
- State
- Utah
- ZIP Code
- 84084
- Phone
- (801) 566-8540
Authorized Official
- Name
- JACOB WARNER
- Title
- CREDENTIALING MANAGER
- Phone
- (801) 691-1701
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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