Organization
WASATCH DENTAL GROUP LLC
Active
Other names
Oquirrh Mountain Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANE J NELSON DMD (OWNER/PARTNER/DENTIST)
(801) 254-7003
Entity
Organization
Contact information
Practice address
1685 W TOWNE CENTER DR, SOUTH JORDAN, UT 84095-8697
(801) 254-7003
(801) 281-8455
Mailing address
1685 W TOWNE CENTER DR, SOUTH JORDAN, UT 84095-8697
(801) 254-7003
(801) 281-8455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164883104
NPI
UT
Enumeration date
05/26/2020
Last updated
05/26/2020
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