Organization
CORNER CLINIC DENTAL STG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB HEYWOOD (CFO)
(435) 671-3285
Entity
Organization
Contact information
Practice address
2351 S RIVER RD STE 4, ST GEORGE, UT 84790-8749
(435) 709-8786
Mailing address
380 E MAIN ST BLDG B2ND, MIDWAY, UT 84049-6801
(435) 659-7352
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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