# WASATCH PEDIATRIC DENTISTRY, PC

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

## Provider details

- **NPI number:** 1487216685
- **Authorized official:** DR. KURT VEST DMD (OWNER)
- **Authorized official phone:** (435) 999-0234

## Contact information

- **Practice address:** 530 W 465 N STE 703, PROVIDENCE, UT 84332-8006
- **Practice address phone:** (435) 999-0234
- **Practice address fax:** (435) 363-9151
- **Mailing address:** 1765 E 2450 N, NORTH LOGAN, UT 84341-4705
- **Mailing address phone:** (801) 360-8775
- **Mailing address fax:** (435) 514-1743

## Taxonomy

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

## Other

- **Enumeration date:** 07/08/2019
- **Last updated:** 02/05/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1457794315 | — | UT |