Organization
ABUNDANT DENTAL CARE, P.C.
Active
Parent organization
ABUNDANT DENTAL CARE, P.C.
Other names
Abundant Dental Care of Riverton, Riverton Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
ABUNDANT DENTAL CARE, P.C.
Authorized official
TRACIE SULLIVAN (DIRECTOR OF ACCOUNTS RECEIVABLE)
(801) 849-1045
Entity
Organization
Contact information
Practice address
3409 W 12600 S STE 100, RIVERTON, UT 84065-7266
(801) 561-1559
Mailing address
793 E WINCHESTER ST, MURRAY, UT 84107-7564
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
UT
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
N/A
—
Enumeration date
06/23/2017
Last updated
04/22/2021
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