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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