Organization
EAGLE MOUNTAIN DENTAL, LLC
Active
Other names
Brigham City Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MURDOCK DDS (OWNER)
(435) 734-2248
Entity
Organization
Contact information
Practice address
30 E 700 S, BRIGHAM CITY, UT 84302-3235
(435) 734-2248
(435) 723-0778
Mailing address
30 E 700 S, BRIGHAM CITY, UT 84302-3235
(435) 734-2248
(435) 723-0778
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4931937
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
GENERAL DENTIST
—
Enumeration date
07/24/2017
Last updated
07/21/2022
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