Pdc Provo Llc is a General Practice in Provo, Utah. Pdc Provo Llc practices all healthcare services and medical treatments related to General Practice. The NPI Number for Pdc Provo Llc is 1396893012. The last update date is 2013-01-04.
Pdc Provo Llc's current location address is 2520 N Univ Ave, Provo, Utah. You can contact this provider via phone number 8014266255 and fax number 8012242966. The mailing address for Pdc Provo Llc is 2520 N Univ Ave, Provo, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pdc Provo Llc |
|---|---|
| Address | 2520 N Univ Ave, Provo, Utah |
| Phone Number | 8014266255 |
| Fax Number | 8012242966 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OFFICE MAN |
|---|---|
| Authorized Official Name | Johnson Amber |
| Telephone Number | 8014266255 |
NPI Number Detail
| NPI Number | 1396893012 |
|---|---|
| Provider Enumeration Date | 2007-01-08 |
| Last Updated Date | 2013-01-04 |
Provider Mailing Address Detail
| Address | 2520 N Univ Ave |
|---|---|
| City | Provo |
| State | Utah (UT) |
| Post Code | 84604 |
| Phone Number | 8014266255 |
| Fax Number | 8012242966 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 3192 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 529113131001 | UT | -- |
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What is the unique 10-digit identification code issued to Pdc Provo Llc by the Centers for Medicare & Medicaid Services?
The Pdc Provo Llc has been assigned the NPI (National Provider Identifier) 1396893012 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Pdc Provo Llc?
The Pdc Provo Llc is physically situated at 2520 N Univ Ave, in the city of Provo, state of UT, with the postal code 84604.
What is the Pdc Provo Llc's specialty and taxonomy code?
The Pdc Provo Llc's specialty is General Practice, and the corresponding taxonomy code is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services assign the 1396893012 to Pdc Provo Llc?
The Centers for Medicare & Medicaid Services assigned the 1396893012 to Pdc Provo Llc on 2007-01-08.
As of what date were the Pdc Provo Llc's details last updated?
The information pertaining to the Pdc Provo Llc, including its address, specialty, and other details, was most recently updated on 2013-01-04.
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