Organization
PROFESSIONAL DENTAL LLC
Active
Parent organization
PROFESSIONAL DENTAL LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROFESSIONAL DENTAL LLC
Authorized official
ROBERT HACK (PRESIDENT)
(801) 636-0110
Entity
Organization
Contact information
Practice address
1240 E HIGHWAY 193, SUITE G-1, LAYTON, UT 84040-8544
(801) 771-6000
(801) 771-7133
Mailing address
PO BOX 1715, OREM, UT 84059-1715
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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