Organization
DANIEL B. VINE, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL B VINE MD (MD)
(801) 288-1115
Entity
Organization
Contact information
Practice address
3980 S 700 E, #23, SALT LAKE CITY, UT 84107-2188
(801) 288-1115
(801) 288-1116
Mailing address
3980 S 700 E, #23, SALT LAKE CITY, UT 84107-2188
(801) 288-1115
(801) 288-1116
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
171413-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
527270415025
—
UT
Enumeration date
10/22/2010
Last updated
10/22/2010
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