| Dentistry For Children West Valley Pc | |
|
3540 S 4000 W Ste 440 West Valley UT 84120-3295 | |
| (801) 955-5200 | |
| (801) 955-1707 |
| Full Name | Dentistry For Children West Valley Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3540 S 4000 W Ste 440, West Valley, Utah |
| Authorized Official Name and Position | Nancy L Davila (OFFICE MANAGER) |
| Authorized Official Contact | 8019555200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentistry For Children West Valley Pc 3540 S 4000 W Ste 440 West Valley UT 84120-3295 Ph: (801) 955-5200 | Dentistry For Children West Valley Pc 3540 S 4000 W Ste 440 West Valley UT 84120-3295 Ph: (801) 955-5200 |
| NPI Number | 1922308618 |
|---|---|
| Provider Enumeration Date | 10/27/2010 |
| Last Update Date | 10/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922308618 | NPI | - | NPPES |
| 529313580001 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5247754 (Utah) | Primary |
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