| Platinum Dental Care-providence | |
|
169 N Gateway Dr Suite #105 Providence UT 84332-9861 | |
| (435) 610-2474 | |
| Not Available |
| Full Name | Platinum Dental Care-providence |
|---|---|
| Speciality | Dentist |
| Location | 169 N Gateway Dr, Providence, Utah |
| Authorized Official Name and Position | Jacob Warner (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8016911701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Platinum Dental Care-providence Po Box 970238 Orem UT 84097-0309 Ph: (801) 691-1701 | Platinum Dental Care-providence 169 N Gateway Dr Suite #105 Providence UT 84332-9861 Ph: (435) 610-2474 |
| NPI Number | 1598390494 |
|---|---|
| Provider Enumeration Date | 03/11/2020 |
| Last Update Date | 03/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598390494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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