Organization
SALT LAKE MODERN DENTISTRY, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM BURR (OWNER)
(801) 438-6355
Entity
Organization
Contact information
Practice address
1028 E 2100 S STE 3, SALT LAKE CITY, UT 84106-3096
(801) 438-6355
(801) 386-5639
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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