Pdc Provo LLC
Pdc Provo LLC is a Dentist in Provo, Utah. Licensed in Utah. Registered with an NPI since 2007.
- Licensed in
- UT
- In the registry since
- 2007
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
2520 N Univ Ave Ste 101Provo, UT 84604
Phone: (801) 426-6255
Fax: (801) 224-2966
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence 6026130 (UT) |
|---|---|
| General Practice Dentistry | Taxonomy 1223G0001X · Licence 3192 (UT) |
Record details
| NPI number | 1396893012 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Platinum Dental Group LLC |
| Authorized official | Amber Johnson — Office Manager · (801) 426-6255 |
| NPI enumerated | January 8, 2007 |
| Last updated in NPPES | January 4, 2013 |
| Mailing address | 2520 N Univ Ave, Suite 101, Provo, UT 84604 |
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