# DANIEL B. VINE, MD, PC

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

## Provider details

- **NPI number:** 1699075895
- **Authorized official:** DANIEL B VINE MD (MD)
- **Authorized official phone:** (801) 288-1115

## Contact information

- **Practice address:** 3980 S 700 E, \#23, SALT LAKE CITY, UT 84107-2188
- **Practice address phone:** (801) 288-1115
- **Practice address fax:** (801) 288-1116
- **Mailing address:** 3980 S 700 E, \#23, SALT LAKE CITY, UT 84107-2188
- **Mailing address phone:** (801) 288-1115
- **Mailing address fax:** (801) 288-1116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 171413-1205 | UT | Yes |

## Other

- **Enumeration date:** 10/22/2010
- **Last updated:** 10/22/2010