Organization
MIDLAND DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANETTE MARY ALLEN (OFFICE MANAGER)
(801) 317-4407
Entity
Organization
Contact information
Practice address
4040 SOUTH MIDLAND DRIVE, SUITE 1, ROY, UT 84067
(801) 317-4407
(801) 605-8304
Mailing address
4040 SOUTH MIDLAND DRIVE, SUITE 1, ROY, UT 84067
(801) 317-4407
(801) 605-8304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6654241-9922
UT
Other
Enumeration date
12/03/2010
Last updated
12/03/2010
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