Organization
INTERMOUNTAIN FAMILY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LOESER (DENTIST)
(801) 573-4300
Entity
Organization
Contact information
Practice address
2414 W 7800 S, WEST JORDAN, UT 84088-4292
(801) 573-4300
Mailing address
2414 W 7800 S, WEST JORDAN, UT 84088-4292
(801) 573-4300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4746306-9922
UT
1223G0001X
General Practice Dentistry
Primary
5898704-9921
UT
1223G0001X
General Practice Dentistry
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Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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