Organization
SUGAR HOUSE DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN MARIE WILSON (EXECUTIVE ASSISTANT)
(540) 419-9422
Entity
Organization
Contact information
Practice address
2114 S HIGHLAND DR, SALT LAKE CITY, UT 84106-2807
(540) 419-9422
Mailing address
3821 EAGLE RIDGE CT, HAMPSTEAD, MD 21074-1360
(410) 804-2709
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9187494-9921
UT
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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