Organization
PREDENTIVE DENTAL COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF SCOTT BURG DDS, MBA (DENTIST-OWNER)
(801) 618-0246
Entity
Organization
Contact information
Practice address
6957 S 1300 E, COTTONWOOD HEIGHTS, UT 84047-1817
(801) 618-0246
Mailing address
6957 S 1300 E, COTTONWOOD HEIGHTS, UT 84047-1817
(801) 618-0246
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5096414
UT
Other
Enumeration date
06/24/2015
Last updated
08/18/2016
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