Organization
WEST JORDAN PDC LLC
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
7555 CENTER VIEW CT, STE 104, WEST JORDAN, UT 84084
(801) 566-8540
(801) 282-5114
Mailing address
PO BOX 970874, OREM, UT 84097-0687
(801) 691-1701
(801) 335-6551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7702761-9922
UT
Other
Enumeration date
05/21/2015
Last updated
07/06/2021
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