Organization · Type 2 NPI
South Ogden Pediatric Dental P.c.
Pediatric Dentistry · Washington Terrace, UT
NPI number
1104834191
Active
Practice location
5275 S. Adams Ave.,, Suite C
Washington Terrace, UT 84405
Fax (801) 334-8411
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | 5118697-9923 (UT) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
About NPI 1104834191
South Ogden Pediatric Dental P.c.'s National Provider Identifier is 1104834191, issued on Aug 4, 2006. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Washington Terrace, UT. The record was last updated on Jun 21, 2011.