| NPI | 1730586355 |
|---|---|
| Doing Business As | PLATINUM DENTAL CARE - PROVO |
| Entity Type | Organization |
| Authorized Contact | JESSIE L KITCHEN Insurance Coordinator 801-305-3460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 3104344) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |