Organization · Type 2 NPI

South Provo PDC PLLC

Dental Clinic/Center · Provo, UT

NPI number 1538946207 Active

Practice location

2211 E Valley Vista Way
Provo, UT 84606-5636

Call (385) 412-6964 Map

Fax (385) 248-5034

Mailing address

PO Box 970185
Orem, UT 84097-0185

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XNone listed

Dental Clinic/Center: Definition to come...

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About NPI 1538946207

South Provo PDC PLLC's National Provider Identifier is 1538946207, issued on Sep 14, 2023. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Provo, UT. The record was last updated on Nov 8, 2023.