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Organization

PEDIATRIC DENTISTRY, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
S. DALE HIBBERT (OWNER)
(801) 774-0770
Entity
Organization

Contact information

Practice address
2112 N HILL FIELD RD STE 1, LAYTON, UT 84041-4023
(801) 774-0770
Mailing address
2112 N HILL FIELD RD STE 1, LAYTON, UT 84041-4023
(801) 774-0770

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
145535
UT
1223P0221X
Pediatric Dentistry
145535
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529130165036
UT
Enumeration date
05/07/2007
Last updated
09/11/2025
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