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Organization

VAN LEEUWEN DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL LEE VAN LEEUWEN D.M.D. (DENTIST/OWNER)
(801) 943-1612
Entity
Organization

Contact information

Practice address
6936 PROMENADE DR, #201, SALT LAKE CITY, UT 84121-3391
(801) 943-1612
(801) 942-6008
Mailing address
6936 SOUTH PROMENADE DR., #201, SALT LAKE CITY, UT 84121
(801) 943-1612
(801) 942-6008

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
138074
UT

Other

Enumeration date
08/25/2008
Last updated
08/25/2008
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