Organization
PDC- LEHI UTAH
Active
Other names
Platinum Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WARNER (CREDENTIALING MANAGER)
(801) 691-1701
Entity
Organization
Contact information
Practice address
785 E 200 S, STE 1, LEHL, UT 84043
(801) 331-8545
(801) 407-1703
Mailing address
PO BOX 970483, OREM, UT 84097
(801) 691-1701
(801) 335-6551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3104344
UT
Other
Enumeration date
12/10/2013
Last updated
07/06/2021
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