Organization
PDC RIVERTON LLC
Active
Other names
Platinum Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
TAELOR JEPPSON (INSURANCE COORDINATOR)
(801) 305-3460
Entity
Organization
Contact information
Practice address
2364 W 12600 S, STE 1A, RIVERTON, UT 84065-7109
(801) 253-8866
Mailing address
2476 N UNIVERSITY PKWY STE 201, PROVO, UT 84604-3869
(801) 305-3460
(801) 692-9083
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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