| Kidz Dental Works | |
|
780 S 2000 W Bldg F2 Syracuse UT 84075 | |
| (801) 776-8176 | |
| (801) 774-9085 |
| Full Name | Kidz Dental Works |
|---|---|
| Speciality | Dentist |
| Location | 780 S 2000 W, Syracuse, Utah |
| Authorized Official Name and Position | Gary Scott Wall (OWNER) |
| Authorized Official Contact | 8017768176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidz Dental Works 780 S 2000 W Bldg F2 Syracuse UT 84075 Ph: (801) 776-8176 | Kidz Dental Works 780 S 2000 W Bldg F2 Syracuse UT 84075 Ph: (801) 776-8176 |
| NPI Number | 1730224643 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 07/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730224643 | NPI | - | NPPES |
| 528902470008 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 266402 (Utah) | Primary |
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