| Cda Practice LLC | |
|
11978 S 700 E Ste 101 Draper UT 84020-9818 | |
| (801) 352-7002 | |
| Not Available |
| Full Name | Cda Practice LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11978 S 700 E Ste 101, Draper, Utah |
| Authorized Official Name and Position | Logan Locke (DENTIST/OWNER) |
| Authorized Official Contact | 8017559243 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cda Practice LLC 11978 S 700 E Ste 101 Draper UT 84020-9818 Ph: (801) 352-7002 | Cda Practice LLC 11978 S 700 E Ste 101 Draper UT 84020-9818 Ph: (801) 352-7002 |
| NPI Number | 1295424232 |
|---|---|
| Provider Enumeration Date | 05/04/2023 |
| Last Update Date | 05/04/2023 |
| Certification Date | 05/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295424232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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