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Organization

SOUTH JORDAN PDC PLLC

Active
Other names
Cornerstone Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUAN CARLOS CHAVEZ DMD (OWNER)
(801) 302-8989
Entity
Organization

Contact information

Practice address
10458 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 302-8989
Mailing address
PO BOX 970113, OREM, UT 84097-0309
(801) 305-3460
(801) 335-6551

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1223P0300X
Periodontics

Other

Enumeration date
05/29/2019
Last updated
05/29/2019
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