Organization
PONY EXPRESS DENTAL DAYBREAK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL TORNOW DMD (OWNER)
(801) 876-7669
Entity
Organization
Contact information
Practice address
5396 W DAYBREAK PARKWAY, SOUTH JORDAN, UT 84009
(801) 876-7669
Mailing address
1308 E EAGLE MOUNTAIN BLVD, EAGLE MOUNTAIN, UT 84005-5412
(801) 876-7669
(801) 407-1782
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5015649-8903
UT
Other
Enumeration date
06/30/2017
Last updated
06/30/2017
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