Organization
MOUNTAIN VISTA DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL RYAN MCCONKIE DDS (MANAGER)
(801) 786-0700
Entity
Organization
Contact information
Practice address
539 N HARRISVILLE RD, SUITE F, HARRISVILLE, UT 84404-3560
(801) 786-0700
(801) 340-5025
Mailing address
539 N HARRISVILLE RD, SUITE F, HARRISVILLE, UT 84404-3560
(801) 786-0700
(801) 340-5025
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5167801
UT
Other
Enumeration date
08/09/2010
Last updated
08/09/2010
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