Organization
MOUNTAIN VALLEY DENTAL GARDNER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN BLAIR GARDNER D.D.S. (DENTIST)
(801) 446-8446
Entity
Organization
Contact information
Practice address
12684 S REDWOOD RD, RIVERTON, UT 84065-6695
(801) 446-8446
Mailing address
12684 S REDWOOD RD, RIVERTON, UT 84065-6695
(801) 446-8446
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
96-326378-9922
UT
Other
Enumeration date
12/13/2006
Last updated
08/22/2020
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