# CORAL DESERT SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346205176
- **Authorized official:** DAN NIELSON (ADMINISTRATOR)
- **Authorized official phone:** (435) 674-5230

## Contact information

- **Practice address:** 1490 E FOREMASTER DR, BUILDING C, ST GEORGE, UT 84790-4488
- **Practice address phone:** (435) 674-5230
- **Practice address fax:** (435) 674-5231
- **Mailing address:** 1490 E FOREMASTER DR, BUILDING C, ST GEORGE, UT 84790-4488
- **Mailing address phone:** (435) 674-5230
- **Mailing address fax:** (435) 674-5231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2005-ASF-52092 | UT | Yes |

## Other

- **Enumeration date:** 04/17/2006
- **Last updated:** 06/09/2017