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Clubhouse Pediatric Dentistry Of West Jordan
Pediatric Dentist in Midvale, Utah
NPI 1639654684

Clubhouse Pediatric Dentistry Of West Jordan is a Pediatric Dentist based in Midvale, UT and is specialized in Pediatric Dentistry. Clubhouse Pediatric Dentistry Of West Jordan practices in Midvale, UT. The NPI Number for Clubhouse Pediatric Dentistry Of West Jordan is 1639654684 and holds a License No. (Utah).

The current practice location address for Clubhouse Pediatric Dentistry Of West Jordan is 1108 E South Union Ave, Midvale, UT and can be reached out via phone at 208-520-1514.

Location: 1108 E South Union Ave, Midvale, UT, 84047-2904
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1639654684
Provider Name
Clubhouse Pediatric Dentistry Of West Jordan
Credential
Provider Entity Type
Organization
Address
1108 E South Union Ave, Midvale, UT, 84047-2904
Phone Number
208-520-1514
Fax Number
Provider Enumeration Date
09/26/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1108 E South Union Ave
City
Midvale
State
Utah
Zip
84047-2904
Phone Number
208-520-1514
Fax Number
person
Provider Business Mailing Address Details
Address
1108 E South Union Ave
City
Midvale
State
Utah
Zip
84047-2904
Phone Number
208-520-1514
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
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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