Organization
BOUNTIFUL RIDGE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK SPENCER MCGOWAN DMD (OWNER)
(801) 203-0290
Entity
Organization
Contact information
Practice address
415 MEDICAL DR STE A200, BOUNTIFUL, UT 84010-4970
(801) 203-0290
(801) 872-4329
Mailing address
415 MEDICAL DR STE A200, BOUNTIFUL, UT 84010-4970
(801) 203-0290
(801) 872-4329
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8008797
UT
Other
Enumeration date
06/29/2017
Last updated
07/21/2022
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