| NPI | 1821838871 |
|---|---|
| Doing Business As | TIMPANOGOS PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Direc Of Cred And Prov Rel 504-638-0303 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-05-28 |