| Wasatch Pediatric Dentistry, Pc | |
|
530 W 465 N Ste 703 Providence UT 84332-8006 | |
| (435) 999-0234 | |
| (435) 363-9151 |
| Full Name | Wasatch Pediatric Dentistry, Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 530 W 465 N Ste 703, Providence, Utah |
| Authorized Official Name and Position | Kurt Vest (OWNER) |
| Authorized Official Contact | 4359990234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wasatch Pediatric Dentistry, Pc 1765 E 2450 N North Logan UT 84341-4705 Ph: (801) 360-8775 | Wasatch Pediatric Dentistry, Pc 530 W 465 N Ste 703 Providence UT 84332-8006 Ph: (435) 999-0234 |
| NPI Number | 1487216685 |
|---|---|
| Provider Enumeration Date | 07/08/2019 |
| Last Update Date | 02/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487216685 | NPI | - | NPPES |
| 1457794315 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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