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Organization
IHC HEALTH SERVICES INC
Active
Organization
IHC HEALTH SERVICES INC
Active
Other names
Southridge Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
SETH GLICKMAN MD (INTMN MEDICAL GROUP PRES/CMO CBC)
(801) 442-2905
Entity
Organization
Contact information
Practice address
3723 W 12600 S STE 430, RIVERTON, UT 84065-7310
(801) 285-4200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 285-4200
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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