| Lake Mountain Dental | |
|
4342 E Pony Express Pkwy Ste 100 Eagle Mountain UT 84005-5773 | |
| (801) 830-4486 | |
| Not Available |
| Full Name | Lake Mountain Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4342 E Pony Express Pkwy Ste 100, Eagle Mountain, Utah |
| Authorized Official Name and Position | Caden Caden (ADMIN) |
| Authorized Official Contact | 8018304486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Mountain Dental 4342 E Pony Express Pkwy Ste 100 Eagle Mountain UT 84005-5773 | Lake Mountain Dental 4342 E Pony Express Pkwy Ste 100 Eagle Mountain UT 84005-5773 Ph: (801) 830-4486 |
| NPI Number | 1518641083 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518641083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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