Organization
PARK CITY PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCI NICOL (VP OF OPERATIONS)
(801) 918-4135
Entity
Organization
Contact information
Practice address
1901 PROSPECTOR AVE, PARK CITY, UT 84060-7207
(435) 649-5001
Mailing address
1901 PROSPECTOR AVE, PARK CITY, UT 84060-7207
(435) 649-5001
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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