Organization
PARK CITY PDC PLLC
Active
Other names
Snow Country Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WARNER (CREDENTIALING MANAGER)
(801) 691-1701
Entity
Organization
Contact information
Practice address
1729 SIDEWINDER DR., STE 102, PARK CITY, UT 84060-7518
(435) 649-9492
(801) 692-9083
Mailing address
PO BOX 970309, OREM, UT 84097-0309
(801) 691-1701
(801) 335-6551
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
352590747
UT
Other
Enumeration date
05/22/2017
Last updated
07/02/2021
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