| The Avenues Family Dentistry | |
|
215 S 1000 E Ste A Salt Lake City UT 84102-2486 | |
| (801) 328-4173 | |
| (801) 322-3995 |
| Full Name | The Avenues Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 215 S 1000 E Ste A, Salt Lake City, Utah |
| Authorized Official Name and Position | Paul Mark Porter (PRESIDENT) |
| Authorized Official Contact | 4357600189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Avenues Family Dentistry 215 S 1000 E Ste A Salt Lake City UT 84102-2486 Ph: (801) 328-4173 | The Avenues Family Dentistry 215 S 1000 E Ste A Salt Lake City UT 84102-2486 Ph: (801) 328-4173 |
| NPI Number | 1093018111 |
|---|---|
| Provider Enumeration Date | 12/11/2010 |
| Last Update Date | 12/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093018111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7828837 (Utah) | Primary |
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