| NPI | 1689333908 |
|---|---|
| Doing Business As | SALT LAKE PEDIATRIC DENTISTRY |
| Former Legal Business Name | SLPD TAYLORSVILLE, LLC |
| Entity Type | Organization |
| Authorized Contact | JOHANNA EILEEN WEBSTER Director Of Operations 801-414-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2022-11-28 |