Organization
MSG DENTAL LLC
Active
Other names
Cougar Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD C GROESBECK DMD (OWNER)
(801) 373-7700
Entity
Organization
Contact information
Practice address
835 N 700 E, PROVO, UT 84606
(801) 373-7700
(801) 370-0762
Mailing address
835 N 700 E, PROVO, UT 84606
(801) 373-7700
(801) 370-0762
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8291219
UT
Other
Enumeration date
10/31/2013
Last updated
07/21/2022
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