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Vine Street Pediatric Dentistry

NPI #1962609644 in Murray, Utah

Provider Information

NPI Number
1962609644
Entity Type
Organization
Organization Name
Vine Street Pediatric Dentistry
Primary Specialty
Dentist - Pediatric Dentistry
Enumeration Date
Jun 27, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
678 E VINE ST
Address 2
SUITE #12
City
Murray
State
Utah
ZIP Code
84107-5546
Phone
(801) 268-1135

Authorized Official

Name
MARCI NICOL
Title
OFFICE MANAGER
Phone
(801) 268-1135

Specialties & Taxonomy Codes

Specialty
Dentist - Pediatric Dentistry — Pediatric Dentistry

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