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Organization

LOGAN PDC PLLC

Active
Other names
Platinum Dental Care
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB WARNER (CREDENTIALING MANAGER)
(801) 691-1701
Entity
Organization

Contact information

Practice address
167 E 200 N, STE 3, LOGAN, UT 84321-4049
(435) 752-3689
(435) 752-8217
Mailing address
PO BOX 970924, OREM, UT 84097-0924
(801) 691-1701
(801) 335-6551

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
289803-9923
UT

Other

Enumeration date
10/06/2016
Last updated
07/02/2021
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