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Organization
BIG KAHUNA DENTAL, LLC DBA ALOHA DENTAL
Active
Organization
BIG KAHUNA DENTAL, LLC DBA ALOHA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASE PEERY (BUSINESS MANAGER)
(801) 969-9669
Entity
Organization
Contact information
Practice address
2792 S 5600 W, WEST VALLEY CITY, UT 84120-5590
(801) 969-9669
(801) 969-9779
Mailing address
2792 S 5600 W, WEST VALLEY CITY, UT 84120-5590
(801) 969-9669
(801) 969-9779
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5672733-9922
UT
1223G0001X
General Practice Dentistry
8919236-9921
UT
1223P0221X
Pediatric Dentistry
Primary
7579613-9923
UT
1223P0221X
Pediatric Dentistry
9474332-9922
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
135181-9924
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
317724-8903
UT
Other
Enumeration date
06/25/2014
Last updated
03/23/2016
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