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Organization
PROVO FAMILY DENTISTRY, LLC
Active
Organization
PROVO FAMILY DENTISTRY, LLC
Active
Other names
The Dental Edge
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY HARDMAN (OFFICE MANAGER)
(801) 373-2693
Entity
Organization
Contact information
Practice address
1355 N UNIVERSITY AVE STE 310, PROVO, UT 84604-2721
(801) 373-2693
Mailing address
1355 N UNIVERSITY AVE STE 310, PROVO, UT 84604-2721
(801) 373-2693
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
275985-9922
UT
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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