Provider Demographics
NPI:1487422010
Name:3G DENTAL LLC
Entity type:Organization
Organization Name:3G DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:T
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-230-8030
Mailing Address - Street 1:814 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337-6733
Mailing Address - Country:US
Mailing Address - Phone:435-257-3880
Mailing Address - Fax:435-257-3887
Practice Address - Street 1:814 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-6733
Practice Address - Country:US
Practice Address - Phone:435-257-3880
Practice Address - Fax:435-257-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty