| Tooele Pdc Pllc | |
|
980 N Main St Tooele UT 84074-1616 | |
| (435) 248-0825 | |
| (435) 843-5490 |
| Full Name | Tooele Pdc Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 980 N Main St, Tooele, 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 |
|---|---|
| Tooele Pdc Pllc Po Box 970353 Orem UT 84097-0353 Ph: (435) 248-0825 | Tooele Pdc Pllc 980 N Main St Tooele UT 84074-1616 Ph: (435) 248-0825 |
| NPI Number | 1306506167 |
|---|---|
| Provider Enumeration Date | 12/21/2021 |
| Last Update Date | 12/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306506167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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