Organization
MODERN DENTAL PROFESSIONALS UTAH, PC
Active
Other names
Monarch Dental - Riverdale
Organization subpart
No
Provider details
NPI number
Authorized official
LILIANA MARTINEZ (CREDENTIALING DIRECTOR)
(949) 308-9792
Entity
Organization
Contact information
Practice address
1140 W RIVERDALE RD, SUITE D, OGDEN, UT 84405-3787
(801) 917-1502
(801) 436-3222
Mailing address
8415 DATAPOINT DR STE 1020, SAN ANTONIO, TX 78229-3277
(210) 929-2814
(210) 615-3626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
04/08/2024
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