VINE STREET PEDIATRIC DENTISTRY NPI 1962609644

NPI Information

VINE STREET PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Murray, 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. VINE STREET PEDIATRIC DENTISTRY NPI is 1962609644. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

678 E VINE ST
SUITE #12
MURRAY, UT
ZIP 84107-546
Phone: (801) 268-1135
Fax: (801) 685-7630

The provider's authorized official is Marci Nicol .
The authorized official title is Office Manager and has the following contact phone number (801) 268-1135.

The enumeration date for this NPI number is 6/27/2007 and was last updated on 8/22/2020.

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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