Provider Demographics
NPI:1902549827
Name:PINEVIEW DENTAL HEALTH PLLC
Entity Type:Organization
Organization Name:PINEVIEW DENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-592-3172
Mailing Address - Street 1:3080 PINEBROOK RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5451
Mailing Address - Country:US
Mailing Address - Phone:435-649-6688
Mailing Address - Fax:
Practice Address - Street 1:3080 PINEBROOK RD STE 2000
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5451
Practice Address - Country:US
Practice Address - Phone:435-649-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-19
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty