Organization
COBBLE CREEK DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK E HARRIS DDS (OWNER / DENTIST)
(801) 399-0458
Entity
Organization
Contact information
Practice address
2274 N 400 E, SUITE 204, NORTH OGDEN, UT 84414-7378
(801) 399-0458
(801) 393-2212
Mailing address
2274 N 400 E, SUITE 204, NORTH OGDEN, UT 84414-7378
(801) 399-0458
(801) 393-2212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6822295
UT
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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