| Creek Capital Ivory Ridge Llc | |
|
3401 N Center St Ste 250 Lehi UT 84043-7501 | |
| (801) 407-6520 | |
| Not Available |
| Full Name | Creek Capital Ivory Ridge Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3401 N Center St Ste 250, Lehi, Utah |
| Authorized Official Name and Position | Marci Nicol (COO) |
| Authorized Official Contact | 8013127122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creek Capital Ivory Ridge Llc 678 E Vine St Ste 10 Murray UT 84107-5500 Ph: (801) 918-4135 | Creek Capital Ivory Ridge Llc 3401 N Center St Ste 250 Lehi UT 84043-7501 Ph: (801) 407-6520 |
| NPI Number | 1033637970 |
|---|---|
| Provider Enumeration Date | 08/30/2017 |
| Last Update Date | 08/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033637970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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