# SOUTH VALLEY PEDIATRIC DENTISTRY

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

## Provider details

- **NPI number:** 1336465830
- **Authorized official:** MRS. ANGIE CATMULL (OFFICE MANAGER)
- **Authorized official phone:** (801) 489-1301

## Contact information

- **Practice address:** 1795 W 500 S, SUITE B3, SPRINGVILLE, UT 84663-3186
- **Practice address phone:** (801) 489-1301
- **Mailing address:** 1795 W. 500 S., SUITE B3, SPRINGVILLE, UT 84663
- **Mailing address phone:** (801) 489-1301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/09/2010
- **Last updated:** 04/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 582779657001 | — | UT |