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Organization
PONY EXPRESS DENTAL OF DRAPER, LLC
Active
Organization
PONY EXPRESS DENTAL OF DRAPER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S TORNOW D.M.D. (DENTIST OWNER)
(505) 947-4253
Entity
Organization
Contact information
Practice address
219 E 12300 S, SUITE I-5, DRAPER, UT 84020-6970
(801) 495-4440
(801) 495-4442
Mailing address
219 E 12300 S, SUITE I-5, DRAPER, UT 84020-6970
(801) 495-4440
(801) 495-4442
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5015649-9923
UT
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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