Organization
LCR DENTAL ROSE PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE CLARK ROMNEY (OWNER)
(801) 541-7787
Entity
Organization
Contact information
Practice address
1409 W 1000 N, SALT LAKE CITY, UT 84116-1605
(801) 532-1402
Mailing address
2215 S PRESTON ST, SALT LAKE CITY, UT 84106-4112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6331945-9922
UT
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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