MAIN STREET DENTAL OF SALT LAKE CITY is a point of service in Salt Lake City, UT. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. MAIN STREET DENTAL OF SALT LAKE CITY NPI is 1245607068. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Main Street Dental Of Salt Lake City.
The provider's business location address is:
3195 S MAIN ST STE 201
SALT LAKE CITY, UT
ZIP 84115-749
Phone: (801) 792-6033
The provider's authorized official is Jennifer D Wilson .
The authorized official title is Manager/owner and has the following contact phone number (801) 792-6033.
The enumeration date for this NPI number is 8/27/2015 and was last updated on 8/27/2015.