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Organization

ANYTIME DENTAL NO. 1, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DRAKE G. VINCENT M.D. (MANAGING MEMBER)
(801) 716-7006
Entity
Organization

Contact information

Practice address
11576 S STATE ST, SUITE 1201, DRAPER, UT 84020-6431
(801) 716-7006
(801) 716-7070
Mailing address
11576 S STATE ST, SUITE 1201, DRAPER, UT 84020-6431
(801) 716-7006
(801) 716-7070

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4737943
UT

Other

Enumeration date
04/01/2014
Last updated
04/01/2014
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