Grandpas Dental Center LLC

NPI #1760819924 in Orem, Utah

Provider Information

NPI Number: 1760819924
Entity Type: Organization
Organization Name: Grandpas Dental Center LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Oct 2, 2013
Last Updated: Oct 2, 2013

Practice Location

Address: 294 W 800 N
City: Orem
State: Utah
ZIP Code: 84057-3858
Phone: (801) 374-5200

Authorized Official

Name: MARCELO ABATTI
Title: MEMBER
Phone: (801) 374-5200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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