South Provo Pdc PLLC
South Provo Pdc PLLC is a Dental Clinic/Center in Provo, Utah. Registered with an NPI since 2023.
- In the registry since
- 2023
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
2211 E Valley Vista WayProvo, UT 84606-5636
Phone: (385) 412-6964
Fax: (385) 248-5034
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
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X |
|---|
Record details
| NPI number | 1538946207 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Vivian Betancourt — Credentialing Specialist · (801) 305-3465 |
| NPI enumerated | September 14, 2023 |
| Last updated in NPPES | November 8, 2023 |
| Certification date | November 8, 2023 |
| Mailing address | Po Box 970185, Orem, UT 84097-0185 |
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Provo Family Dentistry, LLC
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