# PEDIATRIC SMILES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pediatric Smiles of Orem
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366711087
- **Authorized official:** DR. ADAM NICHOLAS SHEPHERD DDS (OWNER/MEMBER)
- **Authorized official phone:** 18012240861

## Contact information

- **Practice address:** 167 N 400 W, SUITE A-4, OREM, UT 84057-1909
- **Practice address phone:** (801) 224-0861
- **Practice address fax:** (801) 804-5899
- **Mailing address:** 167 N 400 W, SUITE A-4, OREM, UT 84057-1909
- **Mailing address phone:** (801) 224-0861
- **Mailing address fax:** (801) 804-5899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 8012319 | UT | Yes |

## Other

- **Enumeration date:** 12/27/2011
- **Last updated:** 12/27/2011