# ROSE PARK PEDIATRIC DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 49534949923
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831338623
- **Legal business name:** 49534949923
- **Authorized official:** DR. RICHARD RYAN JOHANSEN DDS (OWNER)
- **Authorized official phone:** (801) 519-2222

## Contact information

- **Practice address:** 55 N REDWOOD RD STE B, SALT LAKE CITY, UT 84116-3174
- **Practice address phone:** (801) 519-2222
- **Mailing address:** 55 N REDWOOD RD STE B, SALT LAKE CITY, UT 84116-3174
- **Mailing address phone:** (801) 519-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 49534949923 | UT | Yes |

## Other

- **Enumeration date:** 02/18/2009
- **Last updated:** 02/18/2009