NPI 1245607068

Main Street Dental of Salt Lake City

Organisation Point of Service Salt Lake City, UT

Practice location

Address: 3195 S Main St STE 201, Salt Lake City, UT 84115-3749
Phone: (801) 792-6033
Mailing address: 7922 S Goldenpointe Way, West Jordan, UT 84088-7672

Authorised official

Name: Jennifer D Wilson
Title: Manager/Owner
Phone: (801) 792-6033

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

Other Point of Service providers in Utah →

Registry record

NPI: 1245607068
Entity type: Organization
NPI issued: 27 Aug 2015
Record last updated: 27 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.