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Organization

BURG PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARCI NICOL (VP OF OPERATIONS)
(801) 918-4135
Entity
Organization

Contact information

Practice address
678 E VINE ST, STE 10, MURRAY, UT 84107-5546
(801) 918-4135
Mailing address
678 E VINE ST, STE 10, MURRAY, UT 84107-5546
(801) 918-4135

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
09/21/2016
Last updated
09/21/2016
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