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1821621129
PRO SMILES UTAH LLC
SOUTH JORDAN, UT
NPI
1821621129
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Entity Type
Organization
Authorized Contact
TANNER M CLARK
Owner/Dentist
801-413-2814
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
Enumeration Date
2020-02-15
Last Update Date
2020-02-15
Business Address
PRO SMILES UTAH LLC
10597 S BEACH COMBER WAY
SOUTH JORDAN, UT 84009-6132
Phone number: 801-413-2814
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Mailing Address
PRO SMILES UTAH LLC
10597 S BEACH COMBER WAY
SOUTH JORDAN, UT 84009-6132
Phone number: 208-317-8555
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