| Wasatch Periodontal Specialists Llc | |
|
4252 S Highland Dr Ste 101 Salt Lake City UT 84124-2684 | |
| (801) 783-6249 | |
| Not Available |
| Full Name | Wasatch Periodontal Specialists Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 4252 S Highland Dr Ste 101, Salt Lake City, Utah |
| Authorized Official Name and Position | Daniel Thunell (MEMBER) |
| Authorized Official Contact | 8017836249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wasatch Periodontal Specialists Llc 4252 S Highland Dr Ste 101 Salt Lake City UT 84124-2684 Ph: (801) 783-6249 | Wasatch Periodontal Specialists Llc 4252 S Highland Dr Ste 101 Salt Lake City UT 84124-2684 Ph: (801) 783-6249 |
| NPI Number | 1962162412 |
|---|---|
| Provider Enumeration Date | 12/26/2021 |
| Last Update Date | 12/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962162412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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