Organization · Type 2 NPI

Provo Family Dentistry, LLC

Dental Clinic/Center · Provo, UT

NPI number 1063923258 Active

Practice location

1355 N University Ave Ste 310
Provo, UT 84604-2721

Call (801) 373-2693 Map

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000X275985-9922 (UT)

Dental Clinic/Center: Definition to come...

2 other providers at this address

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About NPI 1063923258

Provo Family Dentistry, LLC's National Provider Identifier is 1063923258, issued on Oct 16, 2017. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Provo, UT. The record was last updated on Oct 16, 2017.