Organization
GRANDPAS DENTAL CARE OF UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA RODRIGUES (MEMBER)
(801) 576-1444
Entity
Organization
Contact information
Practice address
53 W 10600 S, SANDY, UT 84070-4160
(801) 576-1444
Mailing address
53 W 10600 S, SANDY, UT 84070-4160
(801) 576-1444
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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