Salt Lake Pediatric Dentistry
Salt Lake Pediatric Dentistry provides Dentist services in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2014.
- Licensed in
- UT
- In the registry since
- 2014
- Specialties on file
- 2
Practice location Address checks out
1548 E 4500 S Ste 102Salt Lake City, UT 84117-5209 Not confirmed with CMS for 12 years — call before visiting
Phone: (801) 463-1900
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence 6273877 (UT) |
|---|---|
| Dentist | Taxonomy 122300000X · Licence 7348465 (UT) |
Record details
| NPI number | 1538577655 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeffrey Rupp — Owner · (801) 463-1900 |
| NPI enumerated | August 1, 2014 |
| Last updated in NPPES | August 1, 2014 |
| Mailing address | 1548 E 4500 S Ste 102, Salt Lake City, UT 84117-5209 |
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