# TIMPANOGAS PEDIATRIC DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225184625
- **Authorized official:** MR. SCOTT A JENSEN (SURGEON)
- **Authorized official phone:** (801) 492-1346

## Contact information

- **Practice address:** 25 NORTH 1100 EAST, AMERICAN FORK, UT 84003
- **Practice address phone:** (801) 492-1346
- **Practice address fax:** (801) 492-1320
- **Mailing address:** 25 NORTH 1100 EAST, AMERICAN FORK, UT 84003
- **Mailing address phone:** (801) 492-1346
- **Mailing address fax:** (801) 492-1320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3085413-9923 | UT | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 07/15/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 518047570014 | — | UT |