Pdc Provo Llc is a Dental Clinic in Provo, Utah. This organization is also known as sub part of Platinum Dental Group Llc. It is located at 2520 N Univ Ave, Suite 101, Provo, UT and its contact number is 801-426-6255. The authorized person for Pdc Provo Llc is Amber Johnson
who is Office Manager of the clinic and their contact number is 801-426-6255. The primary license number for Pdc Provo Llc is 6026130 (Dentist) in Utah.
Pdc Provo Llc Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Pdc Provo Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Pdc Provo Llc |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 2520 N Univ Ave, Suite 101, Provo,
Utah, 84604 |
| Phone: | 801-426-6255 |
| Fax: | 801-224-2966 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Amber Johnson |
| Position: | Office Manager |
| Contact Number: | 801-426-6255 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Pdc Provo Llc clinic are as mentioned below.
| NPI Number: | 1396893012 |
| Parent Organization: | Platinum Dental Group Llc |
| NPI Enumeration Date: | 08 Jan, 2007 |
| NPI Last Update On: | 04 Jan, 2013 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pdc Provo Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | 6026130 | Utah | Primary | |
| General Practice | 3192 | Utah | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 529113131001 | Medicaid | Utah | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Pdc Provo Llc
2520 N Univ Ave, Suite 101
Provo, Utah |
| Zip: | 84604 |
| Phone Number: | 801-426-6255 |
| Fax Number: | 801-224-2966 |
Patients can reach Pdc Provo Llc at
2520 N Univ Ave, Suite 101, Provo, Utah or can
call to book an appointment on 801-426-6255.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.