| NPI | 1598390494 |
|---|---|
| Doing Business As | PLATINUM DENTAL CARE-PROVIDENCE |
| Entity Type | Organization |
| Authorized Contact | JACOB WARNER Credentialing Manager 801-691-1701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |