Organization
NIC-UTAH COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX SWANSON (CEO)
(801) 510-9145
Entity
Organization
Contact information
Practice address
2230 N UNIVERSITY PKWY STE 8B, PROVO, UT 84604-6700
(385) 324-7064
Mailing address
2230 N UNIVERSITY PKWY STE 8B, PROVO, UT 84604-6700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/28/2020
Last updated
08/03/2020
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