Organization
LIBERTY MOUNTAIN DENTAL LLC
Active
Other names
Copper Mountain Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVOR ROSS LINDGREN DDS (PRINCIPAL OWNER (CEO))
(801) 440-5520
Entity
Organization
Contact information
Practice address
6351 W 13400 S STE 100, HERRIMAN, UT 84096-5601
(385) 237-5252
Mailing address
1860 N 40 E, OREM, UT 84057-2235
(801) 440-5520
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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