| Primary Children's Hospital Dental | |
|
100 N Mario Capecchi Dr Salt Lake City UT 84113-1103 | |
| (801) 662-3900 | |
| (801) 662-3908 |
| Full Name | Primary Children's Hospital Dental |
|---|---|
| Speciality | Dentist |
| Location | 100 N Mario Capecchi Dr, Salt Lake City, Utah |
| Authorized Official Name and Position | Katy Welkie (CEO/ADMINISTRATOR) |
| Authorized Official Contact | 8016626225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Children's Hospital Dental Po Box 30180 Salt Lake City UT 84130-0180 Ph: (801) 662-1621 | Primary Children's Hospital Dental 100 N Mario Capecchi Dr Salt Lake City UT 84113-1103 Ph: (801) 662-3900 |
| NPI Number | 1568845048 |
|---|---|
| Provider Enumeration Date | 07/02/2015 |
| Last Update Date | 04/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568845048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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