Organization
ELITE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIRA A HASSAN (PRESIDENT)
(801) 969-2121
Entity
Organization
Contact information
Practice address
3280 W 3500 S, #3, WEST VALLEY, UT 84119-2668
(801) 969-2121
Mailing address
3280 W 3500 S #3, WEST VALLEY, UT 84119
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
69371998903
UT
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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