Organization
PONY EXPRESS DENTAL OF ALPINE
Active
Other names
Alpine Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JANET JENSEN (DIRECTOR OF FINANCE AND OPERATIONS)
(801) 845-7760
Entity
Organization
Contact information
Practice address
20 W MAIN STREET CT STE 100, ALPINE, UT 84004-1889
(801) 845-7760
Mailing address
5396 W DAYBREAK PKWY, SOUTH JORDAN, UT 84009-5900
(801) 845-7760
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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