Organization
PARK CITY PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA COCHRAN (COMPANY COORDINATOR)
(801) 553-8882
Entity
Organization
Contact information
Practice address
1830 PROSPECTOR AVE, PARK CITY, UT 84060-7319
(801) 661-8470
Mailing address
1830 PROSPECTOR AVE, PARK CITY, UT 84060-7319
(801) 661-8470
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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