Provider First Line Business Practice Location Address:
5991 SOUTH 3500 WEST PRICE ORTHODONTICS
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
ROY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84067-6701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-985-1669
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/23/2007