Organization
BIG KAHUNA DENTAL, LLC DBA ALOHA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASE PEERY (BUSINESS MANAGER)
(801) 969-9669
Entity
Organization
Contact information
Practice address
2792 S 5600 W, WEST VALLEY CITY, UT 84120-5590
(801) 969-9669
(801) 969-9779
Mailing address
2792 S 5600 W, WEST VALLEY CITY, UT 84120-5590
(801) 969-9669
(801) 969-9779
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5672733-9922
UT
1223G0001X
General Practice Dentistry
8919236-9921
UT
1223P0221X
Pediatric Dentistry
Primary
7579613-9923
UT
1223P0221X
Pediatric Dentistry
9474332-9922
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
135181-9924
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
317724-8903
UT
Other
Enumeration date
06/25/2014
Last updated
03/23/2016
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