| Pacific West Dental Group | |
|
1792 W 1700 S Ste 101 Syracuse UT 84075-9650 | |
| (801) 614-0099 | |
| (801) 776-3661 |
| Full Name | Pacific West Dental Group |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1792 W 1700 S Ste 101, Syracuse, Utah |
| Authorized Official Name and Position | Cathilyn Self (INSURANCE COORDINATOR) |
| Authorized Official Contact | 8016140099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific West Dental Group 1792 W 1700 S Ste 101 Syracuse UT 84075-9650 Ph: (801) 614-0099 | Pacific West Dental Group 1792 W 1700 S Ste 101 Syracuse UT 84075-9650 Ph: (801) 614-0099 |
| NPI Number | 1811269756 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 01/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811269756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4921068 (Utah) | Primary |
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