Pony Express Dental LLC
NPI #1609315480 in Eagle Mountain, Utah
Provider Information
- NPI Number
- 1609315480
- Entity Type
- Organization
- Organization Name
- Pony Express Dental LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- LAKE MOUNTAIN HEALTH, LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Feb 14, 2017
- Last Updated
- Mar 16, 2017
Practice Location
- Address
- 1308 E. EAGLE MOUNTAIN BLVD
- City
- Eagle Mountain
- State
- Utah
- ZIP Code
- 84005
- Phone
- (801) 876-7669
Authorized Official
- Name
- DR. MICHAEL S TORNOW, DMD
- Title
- COO
- Phone
- (505) 947-4252
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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