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Organization

RIDGE PARK DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GRANT A BROUGH DDS (OWNER/DDS)
(801) 773-5285
Entity
Organization

Contact information

Practice address
2307 N HILL FIELD RD STE 101, LAYTON, UT 84041-6890
(801) 773-5285
(801) 773-2850
Mailing address
2307 N HILL FIELD RD STE 101, LAYTON, UT 84041-6890
(801) 773-5285
(801) 773-2850

Taxonomy

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

Other

Enumeration date
05/11/2020
Last updated
05/11/2020
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