Provider Demographics
NPI:1750190070
Name:WEEKEND DENTAL - UTAH LLC
Entity type:Organization
Organization Name:WEEKEND DENTAL - UTAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:THEURER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-525-2191
Mailing Address - Street 1:6955 S UNION PARK CTR STE 510
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84047-6518
Mailing Address - Country:US
Mailing Address - Phone:801-641-8710
Mailing Address - Fax:
Practice Address - Street 1:2560 E 3300 S # 200
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84109-2749
Practice Address - Country:US
Practice Address - Phone:385-464-3520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEEKEND DENTAL EMERGENCY CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental