| NPI | 1265215347 |
|---|---|
| Doing Business As | JORDAN LANDING PEDIATRIC DENTISTRY DDS |
| Entity Type | Organization |
| Authorized Contact | RYAN RICHARD JOHANSEN Dentist 801-280-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |