Organization
MICHAEL VAN LEEUWEN DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LEE VAN LEEUWEN DMD (PRESIDENT DENTIST)
(801) 943-1612
Entity
Organization
Contact information
Practice address
6936 SOUTH 2475 EAST, SUITE 201, SALT LAKE CITY, UT 84121
(801) 943-1612
(801) 942-6008
Mailing address
6936 SOUTH 2475 EAST, SUITE 201, SALT LAKE CITY, UT 84121
(801) 943-1612
(801) 942-6008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1380749922
UT
Other
Enumeration date
11/15/2006
Last updated
01/27/2014
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