WASATCH PEDIATRIC DENTISTRY PC NPI 1487216685

NPI Information

WASATCH PEDIATRIC DENTISTRY, PC is a pediatric dentistry dentist in Providence, 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. WASATCH PEDIATRIC DENTISTRY, PC NPI is 1487216685. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

169 N GATEWAY DR STE 105
PROVIDENCE, UT
ZIP 84332-861
Phone: (435) 999-0234
Fax: (435) 514-1743

The provider's authorized official is Kurt Vest .
The authorized official title is Owner and has the following contact phone number (435) 999-0234.

The enumeration date for this NPI number is 7/8/2019 and was last updated on 7/8/2019.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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