Central Coast Dental INC

NPI #1598210619 in Gunnison, Utah

Provider Information

NPI Number: 1598210619
Entity Type: Organization
Organization Name: Central Coast Dental INC
Primary Specialty: Dentist
Enumeration Date: Aug 18, 2016
Last Updated: Sep 7, 2016

Practice Location

Address: 85 N 100 E
Address 2: STE B
City: Gunnison
State: Utah
ZIP Code: 84634-0400
Phone: (435) 528-7266

Authorized Official

Name: ERNEST M LARSON
Title: OWNER
Phone: (435) 528-7266

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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