Organization
MALL DENTAL GROUP
Active
Other names
Careers Unlimited
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ALVIN MOLEN D.D.S. (OWNER)
(801) 426-6255
Entity
Organization
Contact information
Practice address
575 UNIVERSITY PKWY, I163, OREM, UT 84097-7400
(801) 426-6255
(801) 224-2966
Mailing address
575 UNIVERSITY PKWY, I163, OREM, UT 84097-7400
(801) 426-6255
(801) 224-2966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
140195-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
516323007001
—
UT
Enumeration date
07/15/2006
Last updated
08/22/2020
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