| Pediatric Dentistry, P.c. | |
|
2112 N Hill Field Rd Ste 1 Layton UT 84041-4023 | |
| (801) 774-0770 | |
| Not Available |
| Full Name | Pediatric Dentistry, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2112 N Hill Field Rd Ste 1, Layton, Utah |
| Authorized Official Name and Position | S. Dale Hibbert (OWNER) |
| Authorized Official Contact | 8017740770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry, P.c. 2112 N Hill Field Rd Ste 1 Layton UT 84041-4023 Ph: (801) 774-0770 | Pediatric Dentistry, P.c. 2112 N Hill Field Rd Ste 1 Layton UT 84041-4023 Ph: (801) 774-0770 |
| NPI Number | 1003028325 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003028325 | NPI | - | NPPES |
| 529130165036 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 145535 (Utah) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 145535 (Utah) | Primary |
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