Providence Pdc Pllc

NPI #1598390494 in Providence, Utah

Provider Information

NPI Number: 1598390494
Entity Type: Organization
Organization Name: Providence Pdc Pllc
Primary Specialty: Dentist
Enumeration Date: Mar 11, 2020
Last Updated: Mar 11, 2020

Practice Location

Address: 169 N GATEWAY DR
Address 2: SUITE #105
City: Providence
State: Utah
ZIP Code: 84332-9861
Phone: (435) 610-2474

Authorized Official

Name: JACOB WARNER
Title: CREDENTIALING MANAGER
Phone: (801) 691-1701

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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Provider Name	Specialty	City
DR. Jason O May, D.D.S.	Dentist	Providence	AI Deep Dive
DR. Jessica Anna Ash	Dentist	Providence	AI Deep Dive
DR. Celeste C Mortenson, DDS	Dentist	Providence	AI Deep Dive
Heather Anne Crouch, DDS	Dentist	Slc	AI Deep Dive

Organizations

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Redwood Dental	Dentist	Providence	AI Deep Dive

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