Organization
MOUNTAIN VIEW PEDIATRIC DENTISTRY OF LAYTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT PACKHAM DDS (MANAGING MEMBER)
(801) 779-2900
Entity
Organization
Contact information
Practice address
195 E GENTILE ST, SUITE #11, LAYTON, UT 84041-3754
(801) 779-2900
Mailing address
195 E GENTILE ST, SUITE #11, LAYTON, UT 84041-3754
(801) 779-2900
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6362621-9922
UT
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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