Organization
PARK CITY DENTAL SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWNETTA KAY ABRAHAM RDH (MANAGER)
(435) 615-8500
Entity
Organization
Contact information
Practice address
1526 UTE BLVD STE 212, PARK CITY, UT 84098-7654
(435) 615-8500
(435) 214-7246
Mailing address
1526 UTE BLVD STE 212, PARK CITY, UT 84098-7654
(435) 615-8500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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