Organization
MODERN DENTAL PROFESSIONALS - UTAH, PC
Active
Other names
Monarch Dental - Bountiful
Organization subpart
No
Provider details
NPI number
Authorized official
LILIANA MARTINEZ (CREDENTIALING DIRECTOR)
(493) 089-7929
Entity
Organization
Contact information
Practice address
24 S. 500 WEST, #A, BOUNTIFUL, UT 84010
(801) 296-1617
Mailing address
8415 DATAPOINT DR STE 1020, SAN ANTONIO, TX 78229-3277
(210) 929-2814
(210) 615-3626
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/25/2014
Last updated
04/08/2024
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