Organization
IVORY RIDGE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCI NICOL (VP OF OPERATIONS)
(801) 918-4135
Entity
Organization
Contact information
Practice address
3401 N CENTER STREET, LEHI, UT 84043-0000
(801) 918-4135
Mailing address
3401 NORTH CENTER STREET, LEHI, UT 84043-0000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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