Organization
FOUR SEASONS DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC S SMITH (OWNER)
(801) 281-0100
Entity
Organization
Contact information
Practice address
4465 S 900 E, SALT LAKE CITY, UT 84124-2469
(801) 281-0100
Mailing address
4465 S 900 E STE 100, SALT LAKE CITY, UT 84124-2695
(801) 281-0100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/31/2016
Last updated
06/02/2016
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