Modern Dental Professionals - Utah, PC

NPI #1740687706 in American Fork, Utah

Provider Information

NPI Number: 1740687706
Entity Type: Organization
Organization Name: Modern Dental Professionals - Utah, PC
Primary Specialty: Dentist
Enumeration Date: Nov 19, 2014
Last Updated: Apr 8, 2024

Practice Location

Address: 476 N 900 W STE A
City: American Fork
State: Utah
ZIP Code: 84003-5200
Phone: (801) 756-5522

Authorized Official

Name: LILIANA MARTINEZ
Title: CREDENTIALING DIRECTOR
Phone: (949) 308-9792

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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