institution
Provo Pediatric Dental
Pediatric Dentist in Provo, Utah
NPI 1184320293

Provo Pediatric Dental is a Pediatric Dentist based in Price, UT and is specialized in Pediatric Dentistry. Provo Pediatric Dental practices in Provo, UT. The NPI Number for Provo Pediatric Dental is 1184320293 and holds a License No. (Utah).

The current practice location address for Provo Pediatric Dental is 745 N 500 W, Provo, UT and can be reached out via phone at 801-373-4200 and via fax at 801-373-0816.

Location: 745 N 500 W, Provo, UT, 84501-2537
institution
Provider Profile Details
NPI Number
1184320293
Provider Name
Provo Pediatric Dental
Credential
Provider Entity Type
Organization
Address
745 N 500 W, Provo, UT, 84501-2537
Phone Number
801-373-4200
Fax Number
801-373-0816
Provider Enumeration Date
02/01/2023
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1811446727 01 UT TYPE 1 NPI
1912072620 01 UT TYPE 1 NPI
1598830291 01 UT TYPE 1 NPI
institution
Provider Business Practice Location Address Details
Address
745 N 500 W
City
State
Zip
84601-1472
Phone Number
801-373-4200
Fax Number
801-373-0816
person
Provider Business Mailing Address Details
Address
745 N 500 W
City
State
Zip
84601-1472
Phone Number
801-373-4200
Fax Number
801-373-0816
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
()
Definition
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.
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