Southridge Pediatric Dentistry
Southridge Pediatric Dentistry provides Dentist services in South Jordan, Utah. Licensed in Utah. Registered with an NPI since 2007.
- Licensed in
- UT
- In the registry since
- 2007
- Specialties on file
- 2
Practice location Address checks out
2651 W 10400 S #103South Jordan, UT 84095
Phone: (801) 445-1515
Fax: (801) 446-5290
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence 343291 (UT) |
|---|---|
| Dentist | Taxonomy 122300000X · Licence 5667938 (UT) |
Record details
| NPI number | 1225249683 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | David Roth — Owner · (801) 446-1515 |
| NPI enumerated | May 25, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 2651 W. 10400 S. #103, South Jordan, UT 84095 |
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