NPI 1790368017 · live from the CMS NPI Registry
Abundant Dental Care, P.C.
Dentist, General Practice in Sandy, UT. National Provider Identifier 1790368017, active.
NPI record
| NPI | 1790368017 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 10497 S State St, Sandy, UT 84070 |
| Practice phone | 801-335-5295 |
| Mailing address | 793 E Winchester St, Murray, UT 84107 |
| Enumerated | May 4, 2021 |
| Last updated | May 4, 2021 |
| Authorized official | Tracie Sullivan, Director Of Accounts Receivable |
| Other names | Abundant Dental Care Of South Town |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.