# DR. DOUG'S PEDIATRIC DENTISTRY P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Small Smiles Pediatric Dentistry P.C.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780004267
- **Authorized official:** DR. KENNETH DOUGLAS FRYER D.D.S., M.S (PRESIDENT)
- **Authorized official phone:** (435) 792-3033

## Contact information

- **Practice address:** 1300 N 200 E, SUITE102, LOGAN, UT 84341-2398
- **Practice address phone:** (435) 232-9721
- **Practice address fax:** (435) 792-3033
- **Mailing address:** 1300 N 200 E, SUITE102, LOGAN, UT 84341-2398
- **Mailing address phone:** (435) 232-9721
- **Mailing address fax:** (435) 792-3033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 285140-9923 | UT | Yes |

## Other

- **Enumeration date:** 04/23/2014
- **Last updated:** 04/23/2014