| NPI | 1790793776 |
|---|---|
| Doing Business As | HIDDEN VALLEY PEDIATRIC DENTAL |
| Entity Type | Organization |
| Authorized Contact | ANNIE C HUFFMAN Billing Manager 801-495-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: UT 5832460) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: UT 342300) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-06-16 |