# ROMNEY PEDIATRIC DENTAL, PLLC

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

## Provider details

- **NPI number:** 1598035172
- **Authorized official:** DR. L. CLARK ROMNEY DMD (DENTIST)
- **Authorized official phone:** (307) 362-3125

## Contact information

- **Practice address:** 525 E 100 S STE 430, SLC, UT 84102-2074
- **Practice address phone:** (801) 532-1402
- **Practice address fax:** (801) 328-3054
- **Mailing address:** 525 E 100 S STE 430, SALT LAKE CITY, UT 84102-2074
- **Mailing address phone:** (307) 362-3125
- **Mailing address fax:** (801) 328-3054

## Taxonomy

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

## Other

- **Enumeration date:** 01/12/2012
- **Last updated:** 04/17/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1598924078 | INDIVIDUAL NPI | — |