| NPI | 1790368017 |
|---|---|
| Doing Business As | ABUNDANT DENTAL CARE OF SOUTH TOWN |
| Entity Type | Organization |
| Authorized Contact | TRACIE SULLIVAN Director Of Accounts Receivable 801-550-3901 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |