Organization
SALT LAKE DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT BLACKWOOD DDS (DENTIST)
(801) 938-8855
Entity
Organization
Contact information
Practice address
279 E 5900 S STE 202, SALT LAKE CITY, UT 84107-5425
(801) 938-8855
(801) 880-9832
Mailing address
279 E 5900 S STE 202, SALT LAKE CITY, UT 84107-5425
(801) 938-8855
(801) 880-9832
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5936346
UT
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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