CHILDREN'S DENTISTRY NPI 1235505587

NPI Information

CHILDREN'S DENTISTRY is a pediatric dentistry dentist in Bountiful, UT. The provider is 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. CHILDREN'S DENTISTRY NPI is 1235505587. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1551 RENAISSANCE TOWNE DR
STE 540
BOUNTIFUL, UT
ZIP 84010-667
Phone: (801) 295-8322

The provider's authorized official is Mark Lyman Nelson .
The authorized official title is Dentist/owner and has the following contact phone number (801) 295-8322.

The enumeration date for this NPI number is 8/20/2015 and was last updated on 8/20/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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