Organization
EAGLE MOUNTAIN CHILDREN'S DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIK ROOKLIDGE DDS (PRESIDENT)
(801) 674-7702
Entity
Organization
Contact information
Practice address
3435 PONY EXPRESS PARKWAY STE. 130, EAGLE MOUNTAIN, UT 84005
(801) 562-2222
Mailing address
10011 S CENTENNIAL PKWY STE 250, SANDY, UT 84070-4121
(801) 562-2222
(801) 562-2230
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529313580002
—
UT
Enumeration date
10/08/2018
Last updated
10/08/2018
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