Organization
HYDE PARK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONTE LAMARR CARLSON D.D.S. (OWNER)
(435) 787-4444
Entity
Organization
Contact information
Practice address
3125 N MAIN ST, SUITE 104, NORTH LOGAN, UT 84341-1547
(435) 787-4444
(435) 787-0044
Mailing address
3125 N MAIN ST, SUITE 104, NORTH LOGAN, UT 84341-1547
(435) 787-4444
(435) 787-0044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1433829922
UT
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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